中国医药
中國醫藥
중국의약
CHINA MEDICINE
2014年
7期
1027-1031
,共5页
任春红%王仕莲%周美艳%张昕
任春紅%王仕蓮%週美豔%張昕
임춘홍%왕사련%주미염%장흔
地佐辛%芬太尼%无痛结肠镜%咪达唑仑
地佐辛%芬太尼%無痛結腸鏡%咪達唑崙
지좌신%분태니%무통결장경%미체서륜
Dezocine%Fentanyl%Painless colonoscopy%Midazolam
目的 探讨阿片类镇痛药物地佐辛联合咪达唑仑用于无痛结肠镜静脉麻醉的镇痛效果与安全性.方法 选取接受无痛结肠镜检查的成年患者120例,按随机数字表随机分为地佐辛组与芬太尼组,每组60例.2组均先给予咪达唑仑0.03 mg/kg缓慢静脉推注,然后地佐辛组缓慢推注地佐辛5.0～7.5 mg,芬太尼组缓慢推注芬太尼0.05～0.1 mg,在患者麻醉至Ramsay镇静分级4级后行结肠镜检查.在术后不同时间点(术后第10、20、30分钟)进行镇痛视觉模拟评分(VAS),监测记录检查时间、患者心率、平均动脉压、血氧饱和度的变化及不良反应发生率.结果 2组患者均安静顺利完成检查,术中各项生命体征稳定,未出现呼吸抑制、呼吸停止及心搏骤停等不良反应.患者术后无明显不良记忆,地佐辛组和芬太尼组术后各时间点(术后第10、20、30 min分钟)VAS评分比较差异均无统计学意义[1.2±0.6比1.3±0.5,t=-0.667;1.1±0.3比1.0±0.7,t=0.685,1.0±0.2比1.0 ±0.3;t=-0.377](均P＞ 0.05).但地佐辛组头晕、恶心呕吐、皮肤瘙痒等不良反应发生率(11.7％,7/60)明显低于芬太尼组的26.7％(18/60)(P＜0.05),芬太尼组患者发生呛咳1例.结论 咪达唑仑联合地佐辛用于无痛结肠镜静脉麻醉,镇痛效果确切,不良反应发生率低,是一种安全、有效的麻醉方法.
目的 探討阿片類鎮痛藥物地佐辛聯閤咪達唑崙用于無痛結腸鏡靜脈痳醉的鎮痛效果與安全性.方法 選取接受無痛結腸鏡檢查的成年患者120例,按隨機數字錶隨機分為地佐辛組與芬太尼組,每組60例.2組均先給予咪達唑崙0.03 mg/kg緩慢靜脈推註,然後地佐辛組緩慢推註地佐辛5.0～7.5 mg,芬太尼組緩慢推註芬太尼0.05～0.1 mg,在患者痳醉至Ramsay鎮靜分級4級後行結腸鏡檢查.在術後不同時間點(術後第10、20、30分鐘)進行鎮痛視覺模擬評分(VAS),鑑測記錄檢查時間、患者心率、平均動脈壓、血氧飽和度的變化及不良反應髮生率.結果 2組患者均安靜順利完成檢查,術中各項生命體徵穩定,未齣現呼吸抑製、呼吸停止及心搏驟停等不良反應.患者術後無明顯不良記憶,地佐辛組和芬太尼組術後各時間點(術後第10、20、30 min分鐘)VAS評分比較差異均無統計學意義[1.2±0.6比1.3±0.5,t=-0.667;1.1±0.3比1.0±0.7,t=0.685,1.0±0.2比1.0 ±0.3;t=-0.377](均P＞ 0.05).但地佐辛組頭暈、噁心嘔吐、皮膚瘙癢等不良反應髮生率(11.7％,7/60)明顯低于芬太尼組的26.7％(18/60)(P＜0.05),芬太尼組患者髮生嗆咳1例.結論 咪達唑崙聯閤地佐辛用于無痛結腸鏡靜脈痳醉,鎮痛效果確切,不良反應髮生率低,是一種安全、有效的痳醉方法.
목적 탐토아편류진통약물지좌신연합미체서륜용우무통결장경정맥마취적진통효과여안전성.방법 선취접수무통결장경검사적성년환자120례,안수궤수자표수궤분위지좌신조여분태니조,매조60례.2조균선급여미체서륜0.03 mg/kg완만정맥추주,연후지좌신조완만추주지좌신5.0～7.5 mg,분태니조완만추주분태니0.05～0.1 mg,재환자마취지Ramsay진정분급4급후행결장경검사.재술후불동시간점(술후제10、20、30분종)진행진통시각모의평분(VAS),감측기록검사시간、환자심솔、평균동맥압、혈양포화도적변화급불량반응발생솔.결과 2조환자균안정순리완성검사,술중각항생명체정은정,미출현호흡억제、호흡정지급심박취정등불량반응.환자술후무명현불량기억,지좌신조화분태니조술후각시간점(술후제10、20、30 min분종)VAS평분비교차이균무통계학의의[1.2±0.6비1.3±0.5,t=-0.667;1.1±0.3비1.0±0.7,t=0.685,1.0±0.2비1.0 ±0.3;t=-0.377](균P＞ 0.05).단지좌신조두훈、악심구토、피부소양등불량반응발생솔(11.7％,7/60)명현저우분태니조적26.7％(18/60)(P＜0.05),분태니조환자발생창해1례.결론 미체서륜연합지좌신용우무통결장경정맥마취,진통효과학절,불량반응발생솔저,시일충안전、유효적마취방법.
Objective To investigate the analgesic effect and safety of dezocine used for intravenous anesthesia combined with midazolam in painless colonoscopy.Methods One hundred and twenty adult patients underwent painless colonoscopy at our hospital were included in the study.Patients were randomly and equally assigned to two groups:dezocine group and fentanyl group.All patients received 0.03 mg/kg midazolam intravenously first.Then patients in dezocine group were slowly injected with 5-7.5 mg dezocine intravenously and 0.05-0.1 mg fentanyl were administered intravenously to patients in fentanyl group before examination.The procedure start when patients reached level of 4 (Ramsay sedation scale score).The standard visual analog scales (VAS) were recorded and compared between two groups at different time points after the procedure to rate the degree of pain.Heart rate (HR),peripheral oxygen saturation (SpO2) and mean arterial pressure (MAP) as well as the side effects were also recorded and compared.Results All patients completed colonoscopy successfully without discomfort and serious complications.There were no statistically significant differences of VAS pain score between dezocine group and fentanyl group at different time points (10,20,30 minutes) after the procedure [1.2 ± 0.6 vs 1.3 ± 0.5,t =-0.667;1.1 ±0.3 vs 1.0±0.7,t=0.685,1.0±0.2 vs 1.0±0.3;t=-0.377] (allP＞0.05).However,the incidence of side effects of fentanyl group including nausea,vomiting,vertigo,bucking and pruritus was significantly higher than dezocine group[26.7％ (18/60) vs 11.7％ (7/60)] (P ＜ 0.05).Conclusion Intravenously administered midazolam and dezocine has less adverse reactions compared with midazolam combined with fentanyl during painless colonoscopy.
