静脉麻醉在门诊胃、肠镜诊断及治疗中的应用.docVIP

精品论文 参考文献 静脉麻醉在门诊胃、肠镜诊断及治疗中的应用 孔霖 林春华 冯艳 方华 肖琴 　　遂宁市第一人民医院 四川遂宁 629000 　　摘要：目的：探讨静脉麻醉在胃肠镜检查的可行性。方法：300例患者随机分成两组，A组：健忘镇痛麻醉组：静脉推注咪达唑仑1~1.5mg，氟哌利多1mg，芬太尼0.075~0.15mg，丙泊酚20mg-30 mg，病人呈浅睡状态后开始置入胃肠镜。术中根据患者反应如肢动和皱眉追加芬太尼0.05mg或丙泊酚10~20mg。B组：芬太尼丙泊酚静脉麻醉组：静注芬太尼0.05mg后缓慢推注丙泊酚1.5~2 mg/kg。观察两组病人在检查过程中生命体征包括血压、心率、呼吸、血氧饱和度的变化，对刺激的耐受性如是否有肢动和呻吟，麻醉及检查的不良反应如血压下降，心率减慢、呼吸抑制等。记录患者清醒时间、离院时间。结果：A组丙泊酚用量明显少于B组，芬太尼用量明显多于B组。清醒时间和离院时间A组明显短于B组。术后不良反应发生率A组明显少于B组。结论：健忘镇痛麻醉用于胃肠镜检查可控性好，呼吸循环抑制比静脉麻醉组轻，清醒时间缩短，检查中患者能配合，减少了术中、术后不良反应的发生，提高了麻醉安全性。 　　关键词：麻醉；丙泊酚；胃镜；肠镜 　　【Abstract】Objective：To study the feasibility of intravenous anesthesia in stomach and check. 　　Methods：300 patients were randomly divided into two groups，group A：forgetful analgesia anesthesia groups：intravenous push note 1 to 1.5 mg，midazolam 1mg，fentanyl 0.075~0.15mg，propofol 20-30mg，began after placing stomach in patients with sleep state.Patients with intraoperative according to effects such as limb movement and frowning additional 0.05 mg or fentanyl 10~20mg.Group B：fentanyl propofol intravenous anesthesia group：after intravenous fentanyl injection 0.05mg slowly push injection of propofol 1.5~2mg.Observed two groups of patients in the process of checking vital signs including blood pressure，heart rate，breathing，the change of blood oxygen saturation，tolerance to stimuli such as limb movement and moan，anesthesia and check the adverse reactions such as blood pressure to drop，slow heart rate，respiratory depression，etc.Record patients awake time，time of departure from the hospital.Results：The dosage of propofol group A significantly less than group B，fentanyl dosage significantly more than group B.Waking hours and time of departure from the hospital group A significantly shorter than group B.Incidence of postoperative adverse reaction in group A significantly less than group B.Conclusion：Analgesic anesthesia check controllability is good for stomach and forgetful，respiratory inhibition of lighter than intravenous anesthesia group，a shor