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1、丙泊酚復(fù)合小劑量舒芬太尼用于無痛胃鏡臨床觀察作者：孫彭齡，李永華，宋澤明，袁紅斌【摘要】目的探討丙泊酚復(fù)合舒芬太尼用于門診無痛胃鏡的安全性和有效性。方法ASAⅠ-Ⅱ級(jí)要求行門診無痛胃鏡檢查的患者120例，隨機(jī)分為3組，即分為丙泊酚+生理鹽水組(P組)、丙泊酚復(fù)合芬太尼組(PF組)和丙泊酚復(fù)合舒芬太尼組(PS組)，每組40例。各組在靜脈注射丙泊酚前分別靜脈注射生理鹽水2ml、芬太尼0.5mg、舒芬太尼0.1μg/kg，待患者睫毛反射消失后插入胃鏡，檢查過程中連續(xù)監(jiān)測(cè)HR、MAP、SpO2，記錄丙泊酚的總量、意識(shí)恢復(fù)時(shí)間、定向力恢復(fù)時(shí)間、胃鏡操作時(shí)間、術(shù)中知
2、曉發(fā)生率等，觀察注藥時(shí)靜脈疼痛、胃鏡檢查中嗆咳、體動(dòng)反應(yīng)、頭暈的情況。結(jié)果三組患者術(shù)中HR、MAP、SpO2與術(shù)前或術(shù)后相比均明顯降低(P<0.05)，各組之間HR、MAP、SpO2比較差異均有統(tǒng)計(jì)學(xué)意義(P<0.05),意識(shí)恢復(fù)時(shí)間、定向力恢復(fù)時(shí)間P組與PF、PS組相比明顯延長(zhǎng)，差異具有統(tǒng)計(jì)學(xué)意義(P<0.05)，PF、PS組之間也有統(tǒng)計(jì)學(xué)意義(P<0.05)。丙泊酚用量P組比PF、PS組增加，差異具有統(tǒng)計(jì)學(xué)意義(P<0.05)，PF、PS組之間無統(tǒng)計(jì)學(xué)差異。結(jié)論丙泊酚復(fù)合小劑量舒芬太尼(0.1μg/kg)不僅可以減少丙泊
3、酚用量、有效降低呼吸抑制等副反應(yīng)，而且能縮短蘇醒時(shí)間，使麻醉更加平穩(wěn)。9【關(guān)鍵詞】胃鏡檢查；麻醉；二異丙酚；舒芬太尼Abstract：ObjectiveToevaluateefficacyandsafetyofpropofol-sufentanylappliedtoanesthesiaofgastrofiberscopy.MethodsOnehundredandtwentypatientsscheduledforelectivegastrofiberscopywererandomizedintothreegroups.GroupP(n=40)wasgiv
4、enintravenousnormalsaline(2ml)beforeadministrationofpropofol,GroupPF(n=40)givenintravenousfentanyl(0.5mg)andthenpropofol,andGroupPS(n=40)givenintravenoussufentanyl(0.1μg/kg)andthenpropofol.Gastrofiberscopywasinsertedaftereyelashesreflexhadbeenextinct.Theparameters,suchasHR,MAP,Sp
5、O2,totaldoseofpropofol,recoveringtimeofconsciousnessandorientation,andawarenesstimeduringoperation,wererecorded.Painfromtheinjectionofpropofol,coughandbody-movementoccurrenceintheoperationwereobserved.ResultsMAP,HRandSpO2wereobviouslylowerinoperationthaninpreoperationorpostoperat
6、ionineachgroup(P<0.05)andwereofsignificantdifferenceamongallthegroups(P<0.05).TherecoveringtimeofconsciousnessandorientationwassignificantlylongerinGroupPthaninGroupPForPS,andtherewassignificantlydifferencebetweenGroupPFandGroupPS(P<0.05).TotaldoseofpropofolinGroupP9wass
7、ignificantlylargerthanthatinGroupPForPS(P<0.05).ConclusionThecombinationofpropofolwithsufentanylappliedtotheoperationofgastrofiberscopycanprovidesatisfactoryanesthesiaeffectswithadvantageoflowerdoseofpropofol,lessrespiratorydepressionandrapidrecoveryafteroperation.Keywords：gas
8、troscopy;anesthesia;propofol;sufentanyl胃
