国际麻醉学与复苏杂志
國際痳醉學與複囌雜誌
국제마취학여복소잡지
INTERNATIONAL JOURNAL OF ANESTHESIOLOGY AND RESUSCITATION
2012年
8期
513-516
,共4页
赵银洁%王伍超%陈扬%龙端阳%严鹏%陈意%葛衡江
趙銀潔%王伍超%陳颺%龍耑暘%嚴鵬%陳意%葛衡江
조은길%왕오초%진양%룡단양%엄붕%진의%갈형강
阿片类镇痛药%异丙酚%无痛胃镜
阿片類鎮痛藥%異丙酚%無痛胃鏡
아편류진통약%이병분%무통위경
Opiod analgesics%Propofol%Painless gastroscopy
目的 评价芬太尼、瑞芬太尼、舒芬太尼复合异丙酚在无痛胃镜诊疗中的应用疗效.方法 接受无痛胃镜检查的患者360例,完全随机分为芬太尼+异丙酚(F)组；瑞芬太尼+异丙酚(R)组；舒芬太尼+异丙酚(S)组,单纯异丙酚对照(C)组,每组90例,每组使用阿片类药物的剂量为等效剂量,异丙酚剂量均为1.5 mg/kg进行双盲实验,观察麻醉过程中各组病例的麻醉效果、麻醉起效及作用时间、阿片样症状的发生率.结果 C组麻醉有效率仅为25.6％,与阿片类各组比较差异均有统计学意义(P＜0.01),F组、R组以及S组麻醉有效率分别为75.6％、94.4％、73.3％,且以R组最高；比较阿片类各组麻醉的有效起效时间,R组(3.90±0.39)s短于F组(9.05±0.63)s及S组(6.45 ±0.27)s,差异有统计学意义(P＜0.05),而3组麻醉作用时间差异无统计学意义；4组患者麻醉过程中均无严重的心血管抑制,C组无腹壁僵直、呼吸抑制等阿片样症状发生,而R组腹壁僵直发生率最高(17.78％),氧饱和度下降且低于90％的发生率为10％,两项指标与F组(4.44％、1.11％)、S组(6.67％、1.11％)比较差异有统计学意义(P＜0.05),但R组胃镜检查过程中呛咳、体动反应发生率低.结论 瑞芬太尼复合复合异丙酚在无痛胃镜检查麻醉中麻醉起效快,麻醉效果好,但是阿片样症状明显.
目的 評價芬太尼、瑞芬太尼、舒芬太尼複閤異丙酚在無痛胃鏡診療中的應用療效.方法 接受無痛胃鏡檢查的患者360例,完全隨機分為芬太尼+異丙酚(F)組；瑞芬太尼+異丙酚(R)組；舒芬太尼+異丙酚(S)組,單純異丙酚對照(C)組,每組90例,每組使用阿片類藥物的劑量為等效劑量,異丙酚劑量均為1.5 mg/kg進行雙盲實驗,觀察痳醉過程中各組病例的痳醉效果、痳醉起效及作用時間、阿片樣癥狀的髮生率.結果 C組痳醉有效率僅為25.6％,與阿片類各組比較差異均有統計學意義(P＜0.01),F組、R組以及S組痳醉有效率分彆為75.6％、94.4％、73.3％,且以R組最高；比較阿片類各組痳醉的有效起效時間,R組(3.90±0.39)s短于F組(9.05±0.63)s及S組(6.45 ±0.27)s,差異有統計學意義(P＜0.05),而3組痳醉作用時間差異無統計學意義；4組患者痳醉過程中均無嚴重的心血管抑製,C組無腹壁僵直、呼吸抑製等阿片樣癥狀髮生,而R組腹壁僵直髮生率最高(17.78％),氧飽和度下降且低于90％的髮生率為10％,兩項指標與F組(4.44％、1.11％)、S組(6.67％、1.11％)比較差異有統計學意義(P＜0.05),但R組胃鏡檢查過程中嗆咳、體動反應髮生率低.結論 瑞芬太尼複閤複閤異丙酚在無痛胃鏡檢查痳醉中痳醉起效快,痳醉效果好,但是阿片樣癥狀明顯.
목적 평개분태니、서분태니、서분태니복합이병분재무통위경진료중적응용료효.방법 접수무통위경검사적환자360례,완전수궤분위분태니+이병분(F)조；서분태니+이병분(R)조；서분태니+이병분(S)조,단순이병분대조(C)조,매조90례,매조사용아편류약물적제량위등효제량,이병분제량균위1.5 mg/kg진행쌍맹실험,관찰마취과정중각조병례적마취효과、마취기효급작용시간、아편양증상적발생솔.결과 C조마취유효솔부위25.6％,여아편류각조비교차이균유통계학의의(P＜0.01),F조、R조이급S조마취유효솔분별위75.6％、94.4％、73.3％,차이R조최고；비교아편류각조마취적유효기효시간,R조(3.90±0.39)s단우F조(9.05±0.63)s급S조(6.45 ±0.27)s,차이유통계학의의(P＜0.05),이3조마취작용시간차이무통계학의의；4조환자마취과정중균무엄중적심혈관억제,C조무복벽강직、호흡억제등아편양증상발생,이R조복벽강직발생솔최고(17.78％),양포화도하강차저우90％적발생솔위10％,량항지표여F조(4.44％、1.11％)、S조(6.67％、1.11％)비교차이유통계학의의(P＜0.05),단R조위경검사과정중창해、체동반응발생솔저.결론 서분태니복합복합이병분재무통위경검사마취중마취기효쾌,마취효과호,단시아편양증상명현.
Objective To evaluate the clinical effects of propofol respectively combined with fentanyl,remifentanil or sufentanil in anesthesia for painless gastroscopy. Methods 360 patients undergoing gastroscopy were randomly divided into four groups:F (fentanyl+propofol),R (remifentanil+propofol),S (sufentanil+propofol),C (propofol).Opioids in four groups were used in equivalent dose and the dosage of propofol in each group was 1.5 mg/kg.Anesthesia effects,onset time and duration of anesthesia with different combinations and the incidence of opioid-related side effects in each group were recorded.The subjects and observers were double-blind to this trial.Results The percentage of satisfactory anesthesia cases in the group C (only 25.6％) waslower than that in the groups F (75.6％),R (94.4％) and S (73.3％) significantly.Comparing the anesthesia onset time of each opiate,it was shorter in group R(3.90±0.39) s than in the group F(9.05±0.63 ) s and the group S (6.45:±0.27) s(P＜0.05 ).There was no significant difference on anesthesia action time in these three groups.No severe cardiac vascular inhibition occurred in all four groups.There were no abdomen rigidity,respiratory depression and other opioid-related side effects happened in the group C.There were higher incidence of abdomen rigidity and significant desaturation(＜90％) in the group R( 17.78％,1.11％) when compared with the group F (4.44％,1.11％ ) and the group S (6.67％,1.11％ )(P＜0.05 ),but lower incidence of bucking and body movement in the group R.Conclusions In anesthesia for painless gastroscopy,more rapid onset of action,better anesthesia effect,but more opioid-related side effects were achieved by using the combination of remifentanil,but not fentanyl and sufentanil,and propofol.
