异丙酚、芬太尼联合静脉麻醉在结肠镜诊疗中的应用

目的：探讨门诊结肠镜诊疗时应用异丙酚＋芬太尼的静脉麻醉效果和安全性。方法：选择门诊结肠镜诊疗的160例患者,观察组80例,予芬太尼0.1mg及2%异丙酚1.5～2mg·kg-1静注,并按130～180μg·kg-1·min-1维持;对照组（80例）仅予单纯异丙酚。比较两组患者诊疗中的反应,诊疗前、中、后的生命体征,以及麻醉组患者麻醉后的清醒时间、自行行走时间。结果：与对照组比较,观察组患者诊疗中的不良反应少,患者的接受率高（98.75%）。对照组诊疗中、诊疗后DBP、SBP、HR、SpO2与诊疗前相比差异无统计学意义（P〉0.05）。对照组诊疗中DBP、SBP、HR较检查前相比明显升高（P〈0.05）,术后约15min内完全恢复正常。结论：结肠镜检查联合使用异丙酚＋芬太尼静脉麻醉,患者痛苦少、起效快,值得推广。

Application of remifentanil combined with propofol intravenous anesthesia for colonoscopy

Objective： To study and compare the anesthetic effect and safety of remlfentanll combined with propofol intravenous anesthesia for out-patient clinic colonoscopy. Methods： 160 patients underwent out-patient clinic colonoscopy were randomly allocated into two groups, 80 cases observed group were injected 0. lmg of 2% fentanyl intravenously,followed by propofol of 1.5-2 mg·kg^-1 intravenous injection, maintained by 130-180μg· kg^-1·min^-1 propofol.Control group B （n=80） were only injected propofol intravenously.Colonoscopy was undergone when patient was in the fourth grade anesthesia state.Heart rate （HR）and SpO2 were continuously monitored. Compare with patients reaction and physical sign,the time for complete colonoscopy,average recovery time and success rate were recorded. Results： Compared with control group, there were less side effect in observed group, and the acceptance rate is higher than that of control group （98.75%）. There were significant differences of the DBP, SBP and HR in control group （P〈0.05）, and the average recovery time was 15 min. Conclusion： The anesthetic side effect and safety of fentanll combined with propofol intravenous anesthesia for colonoscopy is less than propofol intravenous anesthesia only. It had comparable effectiveness and feasibility.