无痛苦胃镜检查并发症临床分析

目的探讨联合应用小剂量芬太尼和异丙酚行无痛苦胃镜检查中并发症的预防和治疗。方法对3180例应用异丙酚及芬太尼静脉复合麻醉后进行胃镜检查，并观察和治疗出现的并发症。结果静注芬太尼和异丙酚后受检者血压、心率、呼吸频率均有不同程度的下降，但绝大多数在正常范围内，无须处理；有6例发生心动过缓，经静注阿托品后心率均恢复正常；1例出现呼吸暂停，经面罩加压给氧后恢复正常；血氧饱和度一过性下降3例，加大氧流量后或不需处理，即可自行恢复正常；咳嗽152例，经增加首剂用药量和避免胃镜碰撞会咽软骨和喉头后咳嗽病例明显减少；有1／3的病人诉注射部位疼痛，后我们先注射利多卡因1ml后此症状消失。膈肌痉挛5例，持续2～5min可自行缓解。结论异丙酚及芬太尼静脉复合麻醉用于胃镜检查是一种安全有效的方法。科学的防治措施是检查成功和减少并发症的关键。

Clinical research of complications of propofol and fentanyl sedation and anesthesia during gastroscopy

Objective Unalytic the complication of propofol and fentanyl sedation and anesthesia during gastroscopy. Methods Three thousand one hundred and eigjhty patients were undergone gastroscopy under propofol and fentanyl sedation and anesthesia. Results Although some patients with intravenous use of propofol and fentanyl , their blood pressure, heart and respiratory rate decreased in different extents, but almost remained in normal range; three cases had bradycardia that was restored after intravenous use of atropine; one case had apnea which could be prevented by masked oxygen; three cases had decreasing of blood oxygen saturation which could be prevented by increasing oxygen inhalation; one hundred and fifty - two cases had cough which could be prevented by increasing the first dose of propofol and avoiding the pharyngeal simulation derived from operation. About 30 % patients complained of pain in the injection site which could be alleviated by intravenous use of lidocaine, Five cases had phreno muscular spasm which could be restored. Conclusion Although gastroscopy under propofol and fentanyl sedation and anesthesia is safe and effective, logical precautions are the keys to attain success and lessen complications.