利多卡因复合丙泊酚在无痛胃镜中应用.docVIP

利多卡因复合丙泊酚在无痛胃镜中应用 　【摘要】 目的 探讨小剂量低浓度利多卡因复合丙泊酚应用于无痛胃镜检查与治疗的临床效果。 方法 将800例行胃镜检查与治疗的患者随机分为两组各400例，研究组应用小剂量低浓度利多卡因复合丙泊酚麻醉，对照组单用丙泊酚麻醉；两组在麻醉前采用心电监测仪监测血压、血氧饱和度、心率、呼吸频率及心电图，取左侧卧位鼻导管吸氧，开放右前臂静脉通道。记录术中两组应用丙泊酚剂量、用药时患者局部刺激反应情况、体动情况、呼吸暂停及心电监测仪监测结果进行对比分析。 结果 研究组麻醉时局部刺激反应发生率、术中体动发生率（咽反射、四肢活动）、丙泊酚应用剂量均显著低于对照组（P＜0.05或0.01）；未发生呼吸暂停现象，患者及胃镜医师满意度均为100%，优于对照组，但无差异性（P＞0.05）。两组心电监测仪监测结果均在正常范围内，但研究组血压、血氧饱和度、心率、呼吸频率较小，SPO2高于对照组。结论 小剂量低浓度利多卡因联合丙泊酚较单用丙泊酚应用于无痛胃镜检查及治疗效果更显著，且生命体征平稳，安全性更高，适用于无痛胃镜的检查与治疗。 【关键词】 无痛胃镜技术；利多卡因；丙泊酚；麻醉；不良反应 【Abstract】 Objective To explore the clinical efficacy of smalldose lightconcentration lidocaine combined with propofol in analgesia gastroscopy and treatment. Methods 800 patients who received gastroscopy and treatment were randomly divided into research group(n=400) anesthetized with smalldose light-concentration lidocaine combined with propofol and control group(n=400) with propofol only; before anesthesia, BP,blood oxygen saturation(BOS), HR, respiratory rate(RR) and ECG were monitored using electrocardioscanner, they inhaled oxygen via nasal catheter taking left lateral position and opened right forearm vein channel. Such parameters as propofol dose, patients? local stimulus reaponse on medication, body movements, apnea and monitoring results of electrocardioscanner were recorded and contrstive analyzed for both groups during operation. Results Local stimulus reaponse and intraoperative body movements(pharynx and limbs? activities) incidence and applied propofol dosage were significantly lower in the research than in the control group(Plt;0.05 or 0.01); in the research group, there was no apnea, degrees of satisfaction for both patients and gastroscope physicians were 100% ,which have an advantage over control group,but difference was no significant(Pgt;0.05). Monitoring results of both groups were within normal limits,but BP,BOS, HR and RR were lower and SPO2 higher in the research than in the control group. Conclusion Effects of smalldose lightconcentration