瑞芬太尼在20例镇痛肠镜检查中的应用.DOCVIP

临床医学论文-瑞芬太尼在20例镇痛肠镜检查中的应用 　［摘要］ ［背景］ 探讨瑞芬太尼和丙泊酚应用于镇痛肠镜检查的可行性. ［病例报告］ 选择ASAⅠ，Ⅱ级需行肠镜检查的患者40例，随机分为瑞芬太尼组及芬太尼组.检查前给予瑞芬太尼组患者1μg/kg瑞芬太尼及1.0～1.5mg/kg丙泊酚静脉滴注，检查中给予瑞芬太尼0.05μg/（kg?min）及丙泊酚2mg/（kg?h）持续静脉滴注至检查结束;检查前芬太尼组患者给予芬太尼0.05mg/kg及丙泊酚1.0～1.5mg/kg静脉滴注，检查中给予丙泊酚2mg/（kg?h）持续静脉滴注，必要时追加滴注丙泊酚30～50mg.在肠镜检查过程中两组患者镇痛效果均较好，芬太尼组1例出现肢体扭动现象，追加静脉滴注丙泊酚后缓解;瑞芬太尼组1例出现肌肉僵硬及气短等症状，经面罩加压给氧后缓解.所有患者检查中生命体征均无明显变化，芬太尼组患者的清醒时间明显长于瑞芬太尼组. ［讨论］ 瑞芬太尼应用于镇痛肠镜检查安全可行. 　　［关键词］? 肠镜检查;镇痛;瑞芬太尼 ??? ABSTRACT:BACKGROUND To study the feasibility of remifentanil and C parked phenol on analgesic enteroscopy.CASE REPORTS40cases of ASAⅠ，Ⅱ-enteroscope inspection patients were selected，and randomly divided into two groups，remifentanil group and fentanil group each20cases.Remifentanil group remifentanil1μg/kg，60seconds slow intravenous drug infusions C parked phenol1.0～1.5mg/kg，intravenous drug infusions games with remifentanil0.05μg/（kg?min）plus C parked phenol2mg/（kg?h）continuous infusion to the end of surgery.Fentanil group controlled0.05mg C parked phenol1.0～1.5mg/kg intravenous drug infusions games with C parked phenol2mg/（kg?h）continued signs and，if necessary，additional C parked phenol30～50mg.After the results of the analgesic effect of the one sets of patients were very satisfied，with the emergence of two cases physically fentanil group Phenomenon.Additional mitigation;remifentanil group C parked phenol after a one cases attracted serious and respiratory depression，with masks， ??? pressurized pulmonary ease.There were no obvious change in the lives of functional indicators in all the patients，games completed more sober time fentanil group obvious extension of the remifentanil group.DISCUSSION Remifentanil phenol for outpatient analgesic enteroscope is safe and feasible.Key words:enteroscopy;analgesia;remifentanil ??? 1 资料与方法 ??? 1.1 一般资料? 选择在丹东市中心医院门诊行镇痛肠镜检查的ASAⅠ，Ⅱ级患者40例，随机分为瑞芬太尼组及芬太尼组，每组各为20例.瑞芬太尼组患者年龄为38～60岁，平均为49岁，体重为56～74kg，平均为65kg;芬太尼组患者年龄为37～59岁，平均为48岁，体重为58～76kg，平均为67kg.两组患者年龄及体重间差异具有可比性. ??? 1.2 方法? 术前禁食水12h