健忘镇痛麻醉在无痛胃肠镜诊疗中的应用

目的探讨健忘镇痛麻醉用于胃肠镜检查的可行性。方法251例患者随机分成两组,A组:健忘镇痛麻醉组:静脉推注咪达唑仑1~1.5 mg,氟哌利多1 mg,芬太尼0.075~0.15 mg,丙泊酚20~30 mg,患者呈浅睡状态后开始置入胃肠镜。术中根据患者反应如肢动和皱眉追加芬太尼0.05 mg或丙泊酚10~20 mg。B组:芬太尼丙泊酚静脉麻醉组:静注芬太尼0.05 mg后缓慢推注丙泊酚1.5~2 mg/kg。观察两组患者在检查过程中生命体征包括血压、心率、呼吸、血氧饱和度的变化,对刺激的耐受性、不良反应。记录患者清醒时间、离院时间。结果A组丙泊酚用量明显少于B组[(33.73±15.79)mg vs(93.26±20.24)mg,P<0.01],芬太尼用量明显多于B组[(0.13±0.04)mg vs(0.07±0.03)mg,P<0.01]。清醒时间[(1.35±0.91)min vs(5.28±3.29)min,P<0.01]和离院时间[(22.72±5.06)min vs(24.02±3.67)min,P<0.05]A组明显短于B组。术后不良反应发生率A组明显少于B组。结论健忘镇痛麻醉用于胃肠镜检查可控性好,不良反应少,进一步提高了麻醉安全性。

Application of analgesic and amnestic anesthesia during painless digestive endoscopy

Objective To research the feasibility of analgesic and amnestic anesthesia during painless digestive endoscopy.Methods 251 cases who need endoscopic examinations and treatments were divided into two groups:group A(126 cases):midazolam 1-1.5 mg,droperidol 1 mg,fentanyl 0.075-0.15 mg,propofol 20-30 mg;group B(control,125cases):fentanyl 0.05 mg,propofol 1.5-2 mg/kg.Result The dosage of fentanyl in group A was more than that in group B and propofol was less than that in group B.A uaking time of group A was shorter than group B and side effects was less than group B.Conclusion Analgesic and amnestic anesthesia had a good controllability,less side effects and proved to be safe.