不同剂量地佐辛联合丙泊酚用于门诊无痛胃镜检查的麻醉效果观察

发布时间：2018-08-02 19:21

【摘要】：目的比较不同剂量地佐辛联合丙泊酚用于门诊无痛胃镜检查的麻醉效果,探讨地佐辛的合理剂量。方法选取择期接受胃镜检查且同意行静脉麻醉患者100例,随机分为D1、D2、D3、F组,各25例。D1组给予地佐辛50ug/kg,D2组地佐辛100ug/kg,D3组地佐辛150ug/kg,F组给予芬太尼1ug/kg。4组患者均给予丙泊酚1~2mg/kg以100mg/min静脉注射,待睫毛反射消失后开始进镜检查,术中根据患者检查情况追加丙泊酚20~50mg/次。比较4组患者入室时(T0)、睫毛反射消失时(T1)、检查结束时(T2)、患者清醒后(T3)的MAP、心率(HR)和射血氧饱和度(SpO_2)及开始给予丙泊酚到睫毛反射消失时间、胃镜检查时间、丙泊酚使用总量、清醒时间(停止给丙泊酚到检查结束后指令睁眼的时间)、离开恢复室时间(检查结束到离开恢复室时间)。观察4组患者给予丙泊酚时患者躁动、术中呼吸抑制、术后恶心呕吐等不良反应发生情况及并发症。结果 MAP、HR、SpO_2时间与方法间有交互作用(P0.05);MAP、HR、SpO_2时间间比较,差异有统计学意义(P0.05);MAP、HR、SpO_2组间比较,差异有统计学意义(P0.05)。T1时4组患者MAP低于T0时,T1时D1组MAP低于D2、D3组,差异有统计学意义(P0.05);T1时F组SpO_2低于D1、D2、D3组,差异有统计学意义(P0.05)。D1组患者丙泊酚使用总量多于其他3组,D3组患者清醒时间长于其他3组,差异有统计学意义(P0.05);4组患者睫毛反射消失时间、胃镜检查时间、离开恢复室时间比较,差异无统计学意义(P0.05)。F组给丙泊酚时患者躁动、术中呼吸抑制、术后恶心呕吐发生率高于其他3组,差异有统计学意义(P0.05,)。4组患者均未出现严重并发症。结论 100ug/kg地佐辛联合丙泊酚用于门诊无痛胃镜检查时呼吸抑制、恶心呕吐、躁动等不良反应少,血流动力学稳定,不延长苏醒时间,是适宜剂量。
[Abstract]:Objective to compare the anesthetic effects of different doses of dizosin combined with propofol for painless gastroscopy in outpatient clinic and to explore the reasonable dose of dizosin. Methods A total of 100 patients undergoing gastroscopy and agreeing to intravenous anesthesia were randomly divided into two groups: group D _ (1) D _ (2) D _ (2) D _ (3) and D _ (1) group (n = 25) were given dizosin 50ugr / kg ~ (2) D _ (2) group, and group D _ (3) were given propofol 1~2mg/kg (n = 25) by 100mg/min intravenous injection. After the eyelash reflex disappeared, the examination was performed. Propofol 20~50mg/ was added according to the patient's examination. The mitogen, heart rate (HR) and ejection oxygen saturation (SpO_2), the time of propofol to mascara disappearance, the time of gastroscopy, and the total amount of propofol were compared between the four groups at the time of entry (T0), the disappearance of mascara reflex (T1), the end of examination (T2), the heart rate (HR) and oxygen saturation of ejection (SpO_2). Awake time (time to stop giving propofol to open eyes after examination), time to leave recovery room (time between end of check and leave recovery room). The adverse reactions such as restlessness, respiratory depression and postoperative nausea and vomiting were observed in 4 groups of patients treated with propofol. Results there was an interaction between the time and method of MAPMA-HRO2 (P0.05). The difference was statistically significant (P0.05). The MAP of D1 group was lower than that of D2D3 group at T1 when MAP was lower than that of D2D3 group (P0.05). The difference was statistically significant (P0.05) the SpO_2 of group F was lower than that of group D _ 1D _ 2 / D _ 3 at T _ 1 (P0.05). The total usage of propofol in group D _ 1 was longer than that in group D _ 3 (P 0.05), and the waking time of group D _ (3) was longer than that of group D _ (3). The difference was statistically significant (P0.05) the time of disappearance of eyelash reflex, the time of gastroscope examination and the time of leaving the recovery room were not significantly different (P0.05) .Group F had no significant difference when the patients were given propofol. The incidence of postoperative nausea and vomiting was higher than that of the other three groups, the difference was statistically significant (P 0.05,) .4 patients had no serious complications. Conclusion 100ug/kg dizosin combined with propofol is an appropriate dose for the treatment of outpatient painless gastroscopy with less adverse reactions such as respiratory depression nausea and vomiting restlessness stable hemodynamics and no prolongation of recovery time.
【作者单位】：武警内蒙古总队医院麻醉科;
【分类号】：R614

【相似文献】