CAJ | 학술논문

[目的]探讨依托咪酯复合地佐辛静脉麻醉在老年患者结肠镜检查的疗效。[方法]选择择期行结肠镜检查老年患者60例，分为三组（ n＝20）：依托咪酯复合地佐辛静脉麻醉组（A组），丙泊酚复合芬太尼静脉麻醉组（B组）和生理盐水对照组（C组），记录三组患者给药前（T0），插镜时（T1），结肠镜过乙状结肠（T2）、脾曲（T3）、肝曲（T4）时的平均动脉压（MAP）、心率（HR）和脉搏血氧饱和度（SpO2）；记录三组患者检查时间、苏醒时间、不适度视觉模拟评分（VAS）、重复检查的依从性评分和术中知晓情况。[结果]60例患者均顺利完成结肠镜检查。A组和B组的检查时间、苏醒时间，术后不适度VAS评分和重复检查的依从性评分均低于C组（ P ＜0．05），但A组和B组之间比较差异无统计学意义（ P ＞0．05）。C组T2、T3和T4时的MAP和HR较T0时升高（ P ＜0．05）；B组T2、T3和T4时的MAP和 HR较T0时降低（ P＜0．05）；A组各时点的MAP和 HR比较差异无统计学意义；与C组比较，A组和B组T2、T3和T4时的MAP和HR均降低（ P ＜0．05）。三组组间和组内脉搏血氧饱和度比较差异均无统计学意义（ P ＞0．05）。A 组和 B组患者均无术中知晓情况，C 组患者检查过程均知晓。[结论]依托咪酯复合地佐辛静脉麻醉可安全有效地用于老年患者结肠镜检查，且患者循环稳定，无明显呼吸抑制。
[목적]탐토의탁미지복합지좌신정맥마취재노년환자결장경검사적료효。[방법]선택택기행결장경검사노년환자60례，분위삼조（ n＝20）：의탁미지복합지좌신정맥마취조（A조），병박분복합분태니정맥마취조（B조）화생리염수대조조（C조），기록삼조환자급약전（T0），삽경시（T1），결장경과을상결장（T2）、비곡（T3）、간곡（T4）시적평균동맥압（MAP）、심솔（HR）화맥박혈양포화도（SpO2）；기록삼조환자검사시간、소성시간、불괄도시각모의평분（VAS）、중복검사적의종성평분화술중지효정황。[결과]60례환자균순리완성결장경검사。A조화B조적검사시간、소성시간，술후불괄도VAS평분화중복검사적의종성평분균저우C조（ P ＜0．05），단A조화B조지간비교차이무통계학의의（ P ＞0．05）。C조T2、T3화T4시적MAP화HR교T0시승고（ P ＜0．05）；B조T2、T3화T4시적MAP화 HR교T0시강저（ P＜0．05）；A조각시점적MAP화 HR비교차이무통계학의의；여C조비교，A조화B조T2、T3화T4시적MAP화HR균강저（ P ＜0．05）。삼조조간화조내맥박혈양포화도비교차이균무통계학의의（ P ＞0．05）。A 조화 B조환자균무술중지효정황，C 조환자검사과정균지효。[결론]의탁미지복합지좌신정맥마취가안전유효지용우노년환자결장경검사，차환자순배은정，무명현호흡억제。
[Objective] To explore the efficacy of intravenous anesthesia with etomidate and dezocine for colonoscopy in elderly patients .[Methods]Sixty ASA Ⅰ ~ Ⅲ elderly patients undergoing elective colonoscopy were randomly divided into etomidate combined with dezocine intravenous anesthesia group (group A ,n=20) ,propofol combined with fentanyl intravenous anesthesia group(group B ,n=20) and normal saline control group(group C ,n=20) .The mean arterial pressure(MAP) ,heart rate(HR) and pulse oxygen saturation(SpO2 ) in 3 groups before administration (T0 ) ,at the beginning of entering the colonoscope(T1 ) ,the colonoscope to the sigmoid colon(T2 ) , to the splenic flexure(T3 ) and hepatic flexure of colon(T4 ) were recorded .The examination time ,the recovery time ,unfitness visual analogue scales(VAS) ,the compliance of repeat examination and intraoperative awareness of 3 groups were recorded .[Results] All 60 patients completed colonoscopy successfully .The examination time ,re-covery time ,postoperative unfitness VAS score and the compliance of repeat examination in group A and group B were lower than those in group C( P <0 .05) ,but there was no significant difference between group A and group B( P >0 .05) .Compared with T0 ,MAP and HR in group C at T2 ,T3 and T4 increased( P<0 .05) ,but those in group B at T2 ,T3 and T4 decreased( P<0 .05) ,and there was significant different in MAP and HR in group A at each time .Compared with group C ,MAP and HR in group A and group B at T2 ,T3 and T4 decreased( P <0 .05) .There was no significant difference in pulse blood oxygen saturation among 3 groups( P >0 .05) .There was no awareness during colonoscopy in group A and B .Patients in group C had awareness during colonoscopy .[Conclusion]Combined Intravenous anesthesia of etomidate combined with dezocine for colonoscopy in elderly pa-tients is safe and effective ,and can maintain stable hemodynamics without obvious respiratory depression .