摘要
目的 探讨不同初始剂量丙泊酚麻醉在无痛胃镜检查中的有效性,安全性和高效性。方法 选择100例胃镜检查患者,ASA I-Ⅲ级,年龄20-80岁,体重50-70 kg,无失代偿心肺疾病,肝肾功能无明显障碍,按照自愿原则分为A、B两组各50例：A组为小初始剂量丙泊酚（1.5-2.0）mg/kg＋局麻药组,B组为较大初始剂量丙泊酚组（2.1-3.0）mg/kg,监测所有患者检查前、中、后的SBP、DBP、HR、Sp O2变化,咽喉反射,体动,睁眼时间,起身站立时间,胃镜操作时间,检查成功率及愿意接受复查率等。结果 A、B两组患者的SBP、DBP、HR和Sp O2没有明显差异,其中A组没有需要抬下颌的患者,B组需要抬下颌的患者有11例,两组均没有呼吸暂停;A、B两组咽喉反射、体动、胃镜操作时间、检查成功率及愿意复诊率差异无统计学意义（P〉0.05）;与B组比较,A组睁眼和起身站立时间均缩短（P〈0.05）。结论 小初始剂量丙泊酚麻醉配合局麻药与单纯较大剂量丙泊酚麻醉在胃镜检查方面有同样完善的抑制咽喉反射和体动的效果,而且前者比后者对呼吸系统的影响更小、更安全,睁眼时间及起身站立时间均明显缩短,说明小初始剂量丙泊酚麻醉在门诊短小手术中更有优势,效率更高。
Objective To investigate the efficacy, safety and efficiency of different initial doses of propofol for anesthe- sia in painless gastroscopy. Methods A total of 100 patients receiving endoscopic examination, with ASA I -11I grade, aged 20-80 years old, weighing 50-70 kg, were selected. They were with no decompensated cardiopulmonary disease, no obvious damage in liver and kidney function. They were assigned into group A and group B, according to the voluntary principle, with 50 patients in each group. Group A was given a small initial dose of propofol for 1.5-2.0 mg/kg＋local anesthetic. Group B was given a large initial dose of propofol for 2.1-3.0 mg/kg. The changes of SBP, DBP, HR, SpO2, pharyngeal reflex, body movement, eye opening time, standing up time, endoscopic operation time, examination success rate and willingness rate of review were monitored before, during and after the examination. Results SBP, DBP, HR and SpO2 of group A and group B were not significantly different. There was no patient in group A who needed to lift the lower jaw, and there were 11 patients in group B who needed to lift the lower jaw. But there was no apnea in the two groups; the rates of pharyngeal reflex, body movement, time of gastroscopy, examination success rate and willingness rate of review were similar between the two groups （P〉0.05）; compared with group B, the eye opening time and the standing up time in group A were shorter （P〈0.05）. Conclusion The small initial dose of propofol anesthesia with lo- cal anesthetic has the same perfect inhibition of pharyngeal reflex and the effect of body movement compared with a single large-dose propofol anesthesia in the endoscopy, and the impact on the respiratory system is smaller and more secure than the latter. Eyes opening time and standing up time are significantly shorter, This indicates that a small ini- tial dose of propofol anesthesia in the outpatient short surgery has more advantages and higher efficiency.
出处
《中国现代医生》
2016年第31期103-105,110,共4页
China Modern Doctor
关键词
丙泊酚
无痛胃镜
咽喉反射
门诊短小手术
高效性
Propofol
Painless gastroscopy
Pharyngeal reflex
Short and small surgery in outpatient clinic
Efficiency
