曲马多联合丙泊酚在无痛肠镜麻醉中的应用

目的 探讨曲马多联合丙泊酚用于无痛肠镜的临床效果及可行性.方法 90例无痛肠镜检查患者,随机分为曲马多组（Q组）,芬太尼组（F组）和对照组（C组）,每组30例,Q组（2mg/kg曲马多）;F组（15ug/kg芬太尼）;C组（3ml生理盐水）,均于3min后予以丙泊酚（1.5 ～2.5）mg/kg静推,术中患者如出现四肢不自主运动时追加丙泊酚.观察并比较三组术中MAP、HR、RR、SP02的变化,记录曲马多,芬太尼,丙泊酚的用量,患者清醒,离院时间,术中发生心动过缓,低血压,低氧血症,呼吸暂停和体动发生率.结果 Q、F组丙泊酚用量明显少于C组（P＜0.05）,F组对血压,心率,呼吸抑制明显（P＜0.05）,而C组的体动发生率明显高于Q、F两组（P＜0.05）.结论 使用无痛肠镜时丙泊酚联合曲马多可以减少丙泊酚的用量,提供良好的镇痛作用,维持术中血流动力学稳定,减少体动发生率,是安全有效并可行的.

Aplication of Tramadol combined with Propofol in Painless Colonoscopy

Objective To explore clinic security and effects of tramadol combined with propofol in painless colonosco- py. Methods Ninety cases conducted painless colonoscopy , ASA I - U stage , which were divided into 3 groups, with every group 30 cases. Group Q （2mg/kg Tramadol ） ; Group F （0.015ug/kg Fentainil） ;C group （3ml Saline）, after 3rains group Q, F,C were given compound propofol 1.5 mg- 2.5mg/kg respectively, observed the changes of the three group＇ s MAP,HR, RR, SPO2 during the operation ; the dosage of propofol, the consciousness vanishing, the sober time, the time discharging from hospital, body involuntary movement and the apnea rate were recorded respectively. Results The total dosage of propofol in group Q,F was obviously decreased （P 〈0.05） ;In group F blood pressure, heart rate, breath were apparently inhibited（P 〈 O. 05 ） ; The involuntary movements happended in group C were clearly increased compared with the other groups （ P 〈 O. 05 ）. Conclusion Tramadol combined with Propofol in painless colonoscopy can reduce the dosage of propofol , produce better painrelieved effects , stabilize the hamodynamic in colonoscopy , reduce body involuntary movements , so it was safe , affective and feasible.