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上海市卫生健康委员会
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CN31-1366/R
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静脉麻醉用于老年患者胃镜检查的临床研究
Comparison of different drugs anesthesia on painless gastroscopy in aged patients

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DOI:
作者:
朱俊峰
ZHU Jun-feng,FENG Zhao-ming.
作者单位:
上海交通大学附属六院金山分院
Departmentof Anesthesiology,The Jinshan Sub-Hospitalof No.6 Hospital affiliated to Shanhai Jiaotong University,Shanghai 201500, China
关键词:
老年人；胃镜检查术；丙泊酚；芬太尼；瑞芬太尼；咪唑安定; 布托啡诺
Aged people;Gastroscopy;Propofol;Fentanyl;Remifantanil;Midazolam. Butorphanol
摘要:
【摘要】目的 探讨不同药物静脉麻醉用于老年患者胃镜检查的有效性及安全性。方法 回顾分析1176例采用静脉麻醉下胃镜检查且年龄≥65岁老年患者的临床资料，按麻醉用药不同分为4组：FP组，芬太尼复合丙泊酚组，260例；RP组，瑞芬太尼复合丙泊酚组，304例；MP组，咪唑安定复合丙泊酚组，288例；BP组，布托啡诺复合丙泊酚组，324例。分析各组丙泊酚用量、病人苏醒时间，术中患者MAP、HR、SpO2变化及不良反应发生情况。结果 所有麻醉均达到满意镇静程度；丙泊酚用量四组[（62.32±20.12）mg、（59.40±17.48）mg、（65.21±20.34）mg、（58.24±18.34）mg]比较无统计学差异；苏醒时间BP组（9.24±2.62）min、MP组（8.60±2.34）min明显长于FP组（6.02±1.62）min和RP组（5.62±1.61）min（P＜0.05）；麻醉后患者MAP、HR、SpO2均一过性下降，其中SpO2 <90% 的发生率，FP组（12%）、MP组（11%）多于RP组（2%）和BP组（3%）（P<0.05）。结论 丙泊酚伍用芬太尼等均可用于老年患者胃镜检查,其中以伍用瑞芬太尼较为理想。
[Abstract] Objective To investigate the effect and security of different drugs on painless gastroscopy in aged patients.Methods 1176 patients aged≥65 years undergoing painless gastroscopy were analyzed retrospectively.The patients were divided into four groups as group FP (intravenous injection with fentanyl and propofol，n=260), group RP(intravenous injection with remifentanil and propofol, n=304)、group MP (intravenous injection with midazolam and propofol, n=288) and group BP (intravenous injection with butorphanol and propofol, n=324).The changes of MAP、HR、SpO2 ,total dosage of propofol,the time patients taking to be awake and adverse effects were analyzed. Results All patients received satisfactory sedation,The total dosage of propofol had no significant difference among groups[（62.32±20.12）mg、（59.40±17.48）mg、（65.21±20.34）mg、（58.24±18.34）mg]; The time patients taking to be awake in group BP（9.24±2.62）min、MP（8.60±2.34）min were longer than that in group FP（6.02±1.62）min and group RP（5.62±1.61）min（P＜0.05）; The MAP、HR and SpO2 were declined after anesthesia in four groups ,the incidences of SpO2 descended <90% in group FP (12%) and group MP (11%) were obviously higher than that in group RP (2 %)and group BP (3 %).Conclusion Propofol with fentanyl、remifantanil、midazolam and butorphanol can be used on painless gastroscopy in aged patients,remifantanil combined with propofol were superior to others.

 

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