舒芬太尼联合依托咪酯在无痛胃肠镜麻醉中的最佳给药间隔时间对比研究

发布时间：2018-01-12 14:26

本文关键词：舒芬太尼联合依托咪酯在无痛胃肠镜麻醉中的最佳给药间隔时间对比研究　出处：《临床合理用药杂志》2016年18期 　论文类型：期刊论文

【摘要】：目的研究舒芬太尼联合依托咪酯在门诊无痛胃肠镜检查麻醉中的最佳用药间隔时间。方法选取梧州市红十字会医院内镜室2014年10月—2015年10月行无痛胃肠镜检查患者160例,根据用药间隔时间不同分为A组、B组、C组和D组,各40例。均给予舒芬太尼0.1μg/kg,依托酯首次剂量0.15~0.20mg/kg,均在30s内注完,其中A组患者注入舒芬太尼后间隔0~2min注入依托咪酯;B组间隔2~5min;C组间隔5~10min;D组间隔10min以上。观察记录4组患者入室后和给药后的血压、心率、Sp O_2、肌颤情况、入镜反应、体动反应、皱眉、舒芬太尼和依托咪酯用量、操作时间、睁眼时间及不良反应等指标。结果 4组患者各组内部血压、心率和Sp O_2的最低值与基础值比较,差异无统计学意义(P0.05),且各组间血压、心率的下降幅度均小于基础值的20%,处于参考范围内。4组患者血压、心率和Sp O_2的最低值比较,差异无统计学意义(P0.05)。A组患者肌颤发生率高于D组,B组肌颤发生率低于C组,C组肌颤发生率高于D组(P0.05)。且B组和D组的肌颤程度相对较轻(P0.05)。4组患者入镜反应发生率、术中体动反应发生率、皱眉发生率比较,差异无统计学意义(P0.05),且任何组别两两比较,差异无统计学意义(P0.05)。4组患者依托咪酯的首量和追加量、舒芬太尼用量比较,差异无统计学意义(P0.05),其中A组依托咪酯首量高于C组(P0.05)。4组患者操作时间及睁眼时间、术中知晓率、术后不良反应比较,差异无统计学意义(P0.05)。结论在无痛胃肠镜麻醉中,先给予舒芬太尼后间隔2~5min再注入依托咪酯,对呼吸、血液循环系统抑制轻,可减轻入镜时的刺激,预防肌颤效果佳,体动反应、皱眉发生程度轻,患者苏醒迅速,几乎无术中记忆,头晕、恶心呕吐等不良反应发生率也较低,患者总体感觉良好。
[Abstract]:Objective to study the best time interval of sufentanil combined with etomidate in painless gastroenteroscopy in outpatient department of anesthesia. Methods from October 2014 to October 2015, the endoscopic room of Wuzhou Red Cross Hospital was selected. 160 patients underwent painless gastroenteroscopy. According to the time interval, the patients were divided into group A (n = 40), group B (n = 40) and group D (n = 40). All patients were given sufentanil (0.1 渭 g / kg), and the first dose of etoetate was 0.15 mg / kg (0.20 mg / kg). Patients in group A were injected with etomidate at intervals of 0 to 2 minutes after injection of sufentanil. The interval between group B and group B was 2: 5 minutes; The interval between group C and group C was 5 minutes and 10 minutes; The blood pressure, heart rate, muscle fibrillation, body movement, frown were observed and recorded in group D after entering room and after administration. Results the lowest values of blood pressure, heart rate and SPO _ 2 in the four groups were compared with the basic values in the four groups, such as the dosage of sufentanil and etomidate, the time of operation, the time of eye opening and adverse reactions. There was no significant difference between the two groups (P 0.05), and the decrease of blood pressure and heart rate in each group was smaller than that in the basic value of 20. The blood pressure of group 4 was within the reference range. There was no significant difference between the lowest value of heart rate and Sp O 2. The incidence of muscle fibrillation in group A was higher than that in group D and group B was lower than that in group C. The incidence of myofibrillation in group C was higher than that in group D (P 0.05), and the degree of myofibrillation in group B and group D was relatively mild. There was no significant difference in the incidence of frown (P 0.05), and there was no significant difference in the initial and additional dose of etomidate in any group. There was no significant difference in the dosage of sufentanil. The first dose of etomidate in group A was higher than that in group C (group C). Conclusion in painless gastroenteroscopic anesthesia, sufentanil was given at intervals of 2 to 5 minutes before injection of etomidate to breathe. The inhibition of blood circulation system is light, can reduce the stimulation when entering the mirror, prevent muscle fibrillation effect well, body movement reaction, frowning degree is light, patient wake up quickly, almost no memory during operation, dizziness. The incidence of adverse reactions such as nausea and vomiting was also low and the patients generally felt good.
【作者单位】：广西梧州市红十字会医院麻醉科;湖北省宜昌市中心人民医院麻醉科;
【分类号】：R614
【正文快照】： 目前临床上在无痛胃肠镜麻醉中多采用芬太尼和异丙酚联合用药,但两者联合对呼吸、血液循环系统均有明显的抑制作用,风险较大。舒芬太尼和依托咪酯作为相应的替代药物,不仅起效快、代谢快、镇静镇痛作用强,而且对呼吸、血液循环系统影响轻微,相对安全,更适用于门诊无痛胃肠镜麻

【相似文献】