国际医药卫生导报
國際醫藥衛生導報
국제의약위생도보
INTERNATIONAL MEDICINE & HEALTH GUIDANCE NEWS
2013年
7期
940-943
,共4页
胡峥嵘%魏兵华%李长科%谭江波%杨建华
鬍崢嶸%魏兵華%李長科%譚江波%楊建華
호쟁영%위병화%리장과%담강파%양건화
舒芬太尼%依托咪酯%清醒镇静镇痛%无痛电子胃镜
舒芬太尼%依託咪酯%清醒鎮靜鎮痛%無痛電子胃鏡
서분태니%의탁미지%청성진정진통%무통전자위경
Sufentanil%Etomidate%Conscious sedation and analgesia%Painless gastroscopy
目的 研究舒芬太尼复合依托咪酯清醒镇静镇痛用于无痛胃镜检查中的有效性、安全性和可行性.方法 选择ASAI~Ⅱ级拟行无痛胃镜检查患者150例,随机分为三组:丙泊酚组(P组)、依托咪酯组(E组)、舒芬太尼复合依托咪酯组(SE组),各50例.P组:丙泊酚1.0 ~ 2.0 mg/kg,E组:依托咪酯0.1~0.2 mg/kg,DE组:舒芬太尼0.1μg/kg+依托咪酯0.1 mg/kg.各组均以60秒匀速静脉推注完毕.检查中均视患者体动情况给予适量缓慢静脉追加注射丙泊酚0.25 ~ 0.5 mg/kg或依托咪酯0.025 ~ 0.05 mg/kg.观察记录三组患者术前、术中的平均动脉压(MAP)、心率(HR)、经皮脉搏血氧饱和度(SP02);记录定向力恢复时间、恢复质量及肌阵挛、心动过缓、血压过低等不良反应情况.结果 三组患者在不同时点的平均动脉压(MAP)、心率(HR)、经皮脉搏血氧饱和度(SPO2)组间比较差异无统计学意义(P>0.05),但与基础值比,P组T1、T2时点MAP、HR、SPO2下降明显,E组和SE组血流动力学明显比P组较平稳;三组定向力恢复时间和患者0AA/S评分结果比较,SE组和P组患者的神志恢复质量明显较E组好,患者术后嗜睡现象明显较少(P<0.05),且恢复时间也较E组迅速,但差异无统计学意义(P>0.05);E组出现肌阵挛4例,而SE组和P组均不超过2例发生,肌阵挛发生率三组间差异有统计学意义(P<0.05).结论 舒芬太尼复合依托咪酯清醒镇静镇痛用于无痛电子胃镜检查能达到满意的麻醉效果,且不良反应少,是一种安全、有效、可靠的麻醉方法.
目的 研究舒芬太尼複閤依託咪酯清醒鎮靜鎮痛用于無痛胃鏡檢查中的有效性、安全性和可行性.方法 選擇ASAI~Ⅱ級擬行無痛胃鏡檢查患者150例,隨機分為三組:丙泊酚組(P組)、依託咪酯組(E組)、舒芬太尼複閤依託咪酯組(SE組),各50例.P組:丙泊酚1.0 ~ 2.0 mg/kg,E組:依託咪酯0.1~0.2 mg/kg,DE組:舒芬太尼0.1μg/kg+依託咪酯0.1 mg/kg.各組均以60秒勻速靜脈推註完畢.檢查中均視患者體動情況給予適量緩慢靜脈追加註射丙泊酚0.25 ~ 0.5 mg/kg或依託咪酯0.025 ~ 0.05 mg/kg.觀察記錄三組患者術前、術中的平均動脈壓(MAP)、心率(HR)、經皮脈搏血氧飽和度(SP02);記錄定嚮力恢複時間、恢複質量及肌陣攣、心動過緩、血壓過低等不良反應情況.結果 三組患者在不同時點的平均動脈壓(MAP)、心率(HR)、經皮脈搏血氧飽和度(SPO2)組間比較差異無統計學意義(P>0.05),但與基礎值比,P組T1、T2時點MAP、HR、SPO2下降明顯,E組和SE組血流動力學明顯比P組較平穩;三組定嚮力恢複時間和患者0AA/S評分結果比較,SE組和P組患者的神誌恢複質量明顯較E組好,患者術後嗜睡現象明顯較少(P<0.05),且恢複時間也較E組迅速,但差異無統計學意義(P>0.05);E組齣現肌陣攣4例,而SE組和P組均不超過2例髮生,肌陣攣髮生率三組間差異有統計學意義(P<0.05).結論 舒芬太尼複閤依託咪酯清醒鎮靜鎮痛用于無痛電子胃鏡檢查能達到滿意的痳醉效果,且不良反應少,是一種安全、有效、可靠的痳醉方法.
목적 연구서분태니복합의탁미지청성진정진통용우무통위경검사중적유효성、안전성화가행성.방법 선택ASAI~Ⅱ급의행무통위경검사환자150례,수궤분위삼조:병박분조(P조)、의탁미지조(E조)、서분태니복합의탁미지조(SE조),각50례.P조:병박분1.0 ~ 2.0 mg/kg,E조:의탁미지0.1~0.2 mg/kg,DE조:서분태니0.1μg/kg+의탁미지0.1 mg/kg.각조균이60초균속정맥추주완필.검사중균시환자체동정황급여괄량완만정맥추가주사병박분0.25 ~ 0.5 mg/kg혹의탁미지0.025 ~ 0.05 mg/kg.관찰기록삼조환자술전、술중적평균동맥압(MAP)、심솔(HR)、경피맥박혈양포화도(SP02);기록정향력회복시간、회복질량급기진련、심동과완、혈압과저등불량반응정황.결과 삼조환자재불동시점적평균동맥압(MAP)、심솔(HR)、경피맥박혈양포화도(SPO2)조간비교차이무통계학의의(P>0.05),단여기출치비,P조T1、T2시점MAP、HR、SPO2하강명현,E조화SE조혈류동역학명현비P조교평은;삼조정향력회복시간화환자0AA/S평분결과비교,SE조화P조환자적신지회복질량명현교E조호,환자술후기수현상명현교소(P<0.05),차회복시간야교E조신속,단차이무통계학의의(P>0.05);E조출현기진련4례,이SE조화P조균불초과2례발생,기진련발생솔삼조간차이유통계학의의(P<0.05).결론 서분태니복합의탁미지청성진정진통용우무통전자위경검사능체도만의적마취효과,차불량반응소,시일충안전、유효、가고적마취방법.
Objective To explore the effectiveness,safety and feasibility of conscious sedation and analgesia with sufentanil combined with etomidate for painless gastroscopy.Methods 150 ASA grade 1 to 2 patients scheduled for painless gastroscopy were randomly divided into three groups:propofol group (group P),etomidate group (group E),and sufentanil combined etomidate group (group SE),50 for each group.Group P received propofol of 1.0-2.0 mg/kg,group E received etomidate of 0.1-0.2 ng/kg,and group DE receievd propofol of 0.1mg/kg and etomidate of 0.1 μ g/kg.All the intravenous injections were completed at a constant speed of 60 seconds.Additional intravenous injections of propofol 0.25-0.5 mg/kg or etomidate 0.025-0.05 mg/kg were administered based on body movements on examination in the patients.Preoperative and intraoperative average artery pressure (MAP),heart rate (HR),and percutaneous oxygen saturation (SPO2)were observed and noted.Time to orientation recovery and quality of recovery,and adverse reactions including myoclonus,bradycardia,and hypotension were noted.Results MAP,HR,and SPO2 at different time points did not differ significantly among the three groups (P>0.05).MAP,HR,and SPO2 decreased significantly group P at T1 and T2,as compared with the baselines; hemodynamics was more stable in groups E and SE than in group P.The quality of consciousness recovery was significantly better in groups SE and P than in group E based on orientation recovery time and OAA/S scores,postoperative somnolence was significantly less (P<0.05),and recovery time was shorter higher,but with no significant statistical differences (P>0.05).4 patients in group E occurred myoclonus whereas no more than 2 patients developed myoclonus in group P or SE,with a statistical significance (P<0.05).Conclusions Conscious sedation and analgesia with sufentanil plus etomidate for painless gastroscopy achieves a satisfactory anesthetic effect and has fewer adverse reactions.It is a safe,effective,reliable approach for anesthesia