摘要
目的分析丙泊酚联合舒芬太尼静脉麻醉后无痛胃镜不同入镜时间点对麻醉效果的影响.方法选择2014-01/2016-12在舟山医院行无痛胃镜检查的60例门诊患者,利用随机数字表法分为对照组与研究组,每组各30例;对照组患者在睫毛反射消失后立即行无痛胃镜检查,而观察组患者在睫毛反射消失后30 s行无痛胃镜检查.比较两组患者麻醉诱导前(T0)、入胃镜前(T1)、胃镜过咽喉(T2)以及镜检完成后(T3)等时间点心率(heart rate,HR)、平均动脉压(mean arterial pressure,MAP)、脉搏血氧饱和度(pulse oxygen saturation,SpO_2)的变化;比较两组患者术后苏醒时间、丙泊酚使用量以及缺氧、心律失常、低血压、呼吸暂停等心肺并发症与记忆出现缺失、呛咳、体动等情况.结果两组患者T0、T1、T2、T3等时间点的HR、MAP及SpO_2比较均无统计学差异(均P>0.05),但两组患者T1、T2时间点MAP均显著低于T0时间点(均P<0.05),T1时间点SpO_2均显著低于T0时间点(均P<0.05).研究组患者的术后苏醒时间、丙泊酚使用量均显著低于对照组患者(均P<0.05).两组患者在缺氧、心律失常、低血压、呼吸暂停及出现记忆缺失等方面不良反应发生率无明显差异(均P>0.05);而研究组患者呛咳、体动反应等不良反应发生率均明显低于对照组患者(均P<0.05).结论丙泊酚联合舒芬太尼静脉麻醉后选择患者睫毛反射消失后延迟30 s入镜检查效果显著,且能够减少丙泊酚使用剂量及患者术后苏醒时间、降低不良反应发生率,值得临床推广使用.
AIM To analyze the impact of timing of gastroscope insertion on the anesthetic effect of propofol and sufentanil for painless gastroscopy.METHODS Sixty patients who would undergo gastroscopy at our hospital from January 2014 to December 2016 were chosen,and they were randomly divided into either a control group or a study group,with 30 cases in each group.The control group underwent gastroscope insertion immediately after the eyelash reflex disappeared,and the observation group underwent gastroscope insertion at 30 s after the eyelash reflex disappeared.Heart rate（HR）,mean arterial pressure（MAP）,and pulse oxygen saturation（SpO2）were compared between the two groups of patients before induction of anesthesia（TO）,before gastroscope insertion（T1）,when the gastroscope passed through the throat（T2）,and at the completion of gastroscopy（T3）.Postoperative awakening tim-,propofol usage,cardiopulmonary complications including hypoxia,arrhythmia,hypotension,and respiratory stop,as well as memory loss,bucking,and body movement.RESULTS The HR,MAP,and SpO2 at the TO,T1,T2,T3 time points had no statistically significant difference in both groups（P 〉 0.05）,but the MAP at Tland T2 were significantly lower than that at TO（P 〈 0.05）and SpO2 at T1 was significantly lower than that at TO in both groups（P 〈 0.05）.Postoperative awakening time and propofol use in the study group were significantly lower than those in the control group（P 〈 0.05）.There was no significant difference between the two groups in hypoxia,arrhythmia,hypotension,apnea,or memory（P 〉 0.05）,but the percentages of patients with cough and body movement in the study group were significantly lower than those in the control group（P 〈 0.05）.CONCLUSION Gastroscope insertion at 30 s after the eyelash reflex disappears following intravenous anesthesia with propofol and sufentanil can reduce propofol dosage,postoperative awakening time,and the incidence of adverse reactions.
作者
袁佳
姚海芳
胡佳艳
Jia Yuan;Jia-Yan Hu;Hai-Fang Yao(Department of Anesthesiology, Zhoushan Hospital, Zhoushan 316000, Zhejiang Province, China;Department of Internal Medicine, Zhoushan Hospital, Zhoushan 316000, Zhejiang Province, Chin)
出处
《世界华人消化杂志》
CAS
2018年第8期494-499,共6页
World Chinese Journal of Digestology
关键词
丙泊酚
舒芬太尼
麻醉
无痛胃镜
入镜时间
Propofol
Sufentanil
Anesthesia
Painlessgastroscopy
Timing of gastroscope insertion
