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目的:观察舒芬太尼复合丙泊酚用于儿童静脉全麻下无痛胃镜检查的麻醉效果及安全性。方法:120例需进行无痛胃镜检查的患儿,通过随机数表法分为观察组(60例)和对照组(60例)。观察组使用舒芬太尼复合丙泊酚麻醉,对照组使用芬太尼复合丙泊酚麻醉。观察两组患儿在T0(麻醉前)、T1(麻醉诱导后1 min)、T2(开始检查)、T3(开始检查后2 min)、T4(结束检测)等时段血流动力学的变化,比较两组麻醉情况、住院时间、丙泊酚用量及麻醉优良率、药品不良反应。结果:在T1、T2、T3时,两组患儿平均动脉压(MAP)、心率(HR)、呼吸频率(RR)均较T0时明显下降(P<0.05);且观察组MAP、HR、RR水平均高于对照组(P<0.05)。观察组意识消失、睁眼、定向力恢复等的时间,以及出院时间均短于对照组,丙泊酚用量少于对照组(P<0.05)。观察组麻醉效果优的例数与比例均多于对照组,呼吸暂停发生率低于对照组(P<0.05)。结论:在儿童无痛胃镜检查中使用舒芬太尼复合丙泊酚进行麻醉起效快、苏醒快、手术过程中血流动力学稳定、安全性高,值得应用推广。
Objective: To observe the anesthetic efficacy and safety of sufentanil combined with propofol for painless gastroscopy under general anesthesia in children. Methods: One hundred and twenty children with painless gastroscopy were divided into observation group (60 cases) and control group (60 cases) by random number table. The observation group was treated with sufentanil combined with propofol and the control group with fentanyl combined with propofol. The changes of hemodynamics during T0 (preanesthesia), T1 (1 min after induction of anesthesia), T2 (start of examination), T3 (2 min after start of examination) and T4 (end of test) The anesthesia, hospital stay, dosage of propofol and the rate of anesthesia were compared between two groups. Adverse reactions were observed. Results: At T1, T2 and T3, mean arterial pressure (MAP), heart rate (HR) and respiratory rate (RR) in both groups were significantly lower than those at T0 (P <0.05) RR levels were higher than the control group (P <0.05). Observation group lost consciousness, eyes open, recovery of orientation and other time, and discharge time were shorter than the control group, the dosage of propofol was less than the control group (P <0.05). The observation group anesthesia superior number and proportion of cases were more than the control group, the incidence of apnea was lower than the control group (P <0.05). Conclusion: The use of sufentanil combined with propofol for painless gastroscopy in children has the advantages of quick onset of anesthesia, rapid recovery, stable hemodynamics and high safety during operation, which is worth popularizing.