异丙芬分别复合芬太尼和米唑安定行无痛胃镜检查的研究

目的 比较异丙芬复合芬太尼或米唑安定用于无痛胃镜检查的有效性和安全性.方法 将180例需要无痛胃镜检查的患者分为A、B、C三组,每组各60例.A组单独静脉注射异丙芬1.5mg/kg,B组先注射芬太尼0.5mg后再注射异丙芬1.5mg/kg,C组先注射米唑安定0.02～0.03 mg/kg后再注射异丙芬1.5 mg/kg.至患者睫毛反射消失后开始插镜检查,如有呛咳、体动等表现时追加异丙芬30～40 mg.记录患者用药前、插镜前、检查结束后各时间点的呼吸、血氧饱和度、血压、心率以及不良反应.结果 B组和C组的异丙芬用量明显少于A组(P＜0.01).B组苏醒最快,没有注射部位疼痛,呛咳、体动等发生率明显低于A组(P＜0.05).结论 异丙芬联合芬太尼组具有麻醉镇痛效果好、副反应少、苏醒快等优点,更适合于无痛胃镜检查.

The study of propofol combined with fentanil or midazolam in painless gastroscopy

Objective To investigate the efficacy and safety of propofol combined with fentanil or midazolam in painless gastroscopy.Methods One hundred eighty ASAI-II patients scheduled for gastroscopy were randomly divided into 3 groups:Simple propofol group(group A,n=60),propofol-fentanil group(group B,n=60)and propofol-midazolam group(group C,n=60).Firstly,patients were given fentanil 0.5 mg intravenously in group B and midazolam 0.02-0.03 mg/kg in group C,then propofol 1.5 mg/kg was injected in both groups,while patients in group A were only injected with propofol 1.5mg/kg.Once the eyelash reflection disappeared,the gastroscope was inserted.If there were the signs of cough or movement,more propofol was given(30-40 mg).HR,SBP,DBP,SPO2 were recorded before anaesthesia,before and after gastroscopy,respectively.At the same time,the total drug consumption,the recovery time and the side effects were also noted.Results The total drug doses were significantly larger in group A than those in group B and C(P<0.01).The recovery time was the shortest in group B,and the incidence of side effects in group B was lower(P<0.05).Conclusions Propofol combined with small dose of fentanil showed better anesthesia efficiency,less side effects and more rapid recovery than simple propofol or propofol combined with midazolam regimens.