无痛胃镜检查前实施局部咽麻作用研究.docVIP

无痛胃镜检查前实施局部咽麻作用研究 　　【摘 要】目的 探讨以丙泊酚联合芬太尼进行无痛胃镜检查前行利多卡因局部咽部麻醉的价值。方法 采用随机双盲研究分析我院320例行无痛胃镜检查的患者，在取得患者及家属同意后，随机将其分为观察组及对照组各160例。观察组采用利多卡因咽部喷雾麻醉，对照组采用生理盐水咽部喷雾，之后两组患者静脉给予丙泊酚联合芬太尼进行检查，观察并记录两组患者的生理参数、麻醉效果，比较两组不同方法的检查时间，丙泊酚用量、咽喉反射以及醒后15min吞咽痛的发生情况。结果 观察组与对照组的生理参数、咽喉反射及肢动情况、吞咽痛等方面无显著性差异。结论 以芬太尼联合丙泊酚进行无痛胃镜检查前行利多卡因局部咽部麻醉无明确优越性。 　　【关键词】无痛胃镜；丙泊酚；利多卡因 　　Study on the role of pharyngeal anesthesia for painless gastroscopy 　　Cao Xinguang，Wang Shujun，Yu Juan，Feng Huimin 　　（Department of General Surgery，Henan Cancer Hospital，Zhengzhou 450052，China） 　　Abstract：Objective To investigate the value of pharyngeal lidocaine anesthesia in combined with Propofol and fentanyl for painless endoscopy 　　Methods We analysed 320cases of patients undergoing painless astroscopy in our hospital by randomized，double-blind，placebo-controlled trial.，they were randomly divided into observation group and control group after obtaining the consent of patients and their families. They are administered 4 squirts of lidocaine spray versus placebo spray immediately before propofol sedation. After intravenous injection of propofol combined with fentanyl，they were examined by gastroscope. Observe and record the patients physiological parameters，anesthetic effect，inspection time，the dosage of propofol，gag reflexes，odynphagia after waking up. Results There were no significant difference between the study group and the control group in physiological parameters，pharyngeal reflex and body movement，odynphagia etc. Conclusion Topical pharyngeal anesthesia does not seem to have an influence on the ease of gag reflex odynphagia in patients sedated with propofol combined with fentanyl. Our study has suggested that topical anesthesia produced no additional benefit when used with deep sedation. 　　Keywords：painless gastroscope；propofol；lidocaine 　　胃镜检查是诊断上消化道疾病最主要的无创或微创的现代化诊疗手段，但是它本身会给受检者带来一定痛苦。无痛胃镜使患者无需再忍受插胃镜所带来的咽喉不适及心理上的不良后果，有效降低患者的应激反应、稳定血流状态，减少胃并发症的出现，有助于胃镜下的诊断与治疗操作。在无痛胃镜检查前是否需要咽部麻醉存在一定争议[1，2]。静脉给予丙泊酚联合芬太尼进行无痛胃镜检查是