异丙酚联合用药与异丙酚单药用于无痛胃镜和肠镜的比较

目的 研究对比单纯异丙酚及其复合芬太尼，咪唑安定用于纤维胃镜和肠镜检查的临床麻醉效果和安全性。方法 300例行无痛胃、肠镜检查的患者，随机均分为3组，异丙酚组（P对照组）；异丙酚复合芬太尼组（PF）先静注芬太尼0．05～0．10mg；异丙酚复合咪唑安定组（PM）先静推咪唑安定0．1mg／kg。然后各组均缓慢推注异丙酚至无睫毛反射后，开始操作，术中视情况追加异丙酚少量。监测并记录各组注药前、注药后1min、5min、15min及操作结束时，各点的SBP、SPO2、HR、RR；记录各组异丙酚总量；各组镇痛效果，肢动情况，清醒后遗忘程度及不良反应。结果 操作中1min与5min SPO2、SBP、RR低于操作前值（P〈0．05）；异丙酚总量PF组和PM明显低于P组（P〈0．01）；两组肢动发生率PF组（5％）和PM（6％）组明显低于P组（13％）;两组呼吸抑制（SPO2〈90％）发生率PF（12％），PM（11％）与P（11％）组相比差异无显著性（P〉0．05）。结论 两种药物联合应用（异丙酚复合芬太尼／咪唑安定）更适合纤维胃镜和肠镜检查。

Comparsion between Propofol combination and Propofol alone in painless gastroscopy and enteroscopy

Objective To compare he effectiveness and safety of clinical anesthesia at combination with Propofol and it alone used to painless gastroscopy and enteroscopy. Methods 300 patients received painless gastroscopy and enteroscopy were randomly divided info 3 groups: Propofol alone (p control group);combition of Propfol and Fentanyl (PF group) was given fentanyl 0.05 to 0. 1 mg intravenous and combition of Propfl and Midazolam(PM group) was given Midazolam (0.1 mg/kg). then Propofol was given for all groups by slow infusion until without lash reflex,then began to operate ,and boosted amounts of profol according to the condition of operation . The SBP, SPO2, HR, RR in all groups before operation and during the following phase as 1, 5, 15 min after injection were determined, also the same way was used for the end of operation, the total amount of propofol in the three groups, analgesic effect,body movement,forget level after consciousness, and adverse reaction were recored. Result There was a statistical difference in The SBP, SPO2, RR of 1 and 5 min in operation is lower than before operaion, the overall amount of propofol in PF and PM group was obviously less than in P group; the incidence of body movement in PF(5%) and PM group (6%) was obviouly less than in P group(13%), the incidence of respiratory inhibition (SPO2 <90%)were respectively 12%(PF group ), 11%(PM group) and 11%(P group) without a significant difference. Conclusion The combination of two drugs(Propofol combination with Midazolam and/or Propofol), was more suitable for the checks of fibergastroscope and fibercolonoscope.