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目的比较异丙酚单纯输注与其分别复合芬太尼、舒芬太尼静脉麻醉用于无痛胃镜的优缺点。方法选取150例行胃镜检查患者,随机分为单纯异丙酚组(P)组、异丙酚复合芬太尼(P+F)组、异丙酚复合舒芬太尼(P+S)组。入室后,吸氧、连接监护仪,分别静注相应剂量的生理盐水、芬太尼及舒芬太尼,10s后推注异丙酚。观察术中MAP、HR、RR、SpO2、异丙酚用量、清醒时间及不良反应。结果三组性别、年龄、体重、手术时间无显著差异(P>0.05)。每组患者术中MAP与术前相比均有明显降低(P<0.05)。三组之间,MAP在术前、术中及术后无明显差异。每组患者术中最低HR及最低SpO2与术前及术后相比均显著下降(P<0.05),但其下降均为一过性,很快恢复正常。P组术中最低HR及最低SpO2明显低于其它两组(P<0.05),其它两组间无明显差异。术中异丙酚的用量P组明显多与其它两组。术后清醒时间P+S组明显短于其它两组(P<0.05)。术中体动的发生率P组(31%)明显高于P+F组(18%)及P+S组(6%),呼吸暂停的发生率三组无明显差异,胃镜医师满意度评分P组明显低于其它两组。结论异丙酚复合芬太尼或舒芬太尼用于无痛胃镜麻醉是一种较为安全有效的方法,尤其是复合舒芬太尼麻醉更平稳,完善,安全,值得推广。
Objective To compare the advantages and disadvantages of simple propofol infusions with fentanyl and sufentanil intravenously for painless gastroscopy. Methods 150 patients undergoing gastroscopy were randomly divided into three groups: propofol group (P), propofol combined with fentanyl (P + F), propofol combined with sufentanil (P + S) . Into the room, oxygen, connected to the monitor, respectively, intravenous infusion of the corresponding dose of normal saline, fentanyl and sufentanil, 10s bolus propofol. The intraoperative MAP, HR, RR, SpO2, propofol dosage, awake time and adverse reactions were observed. Results There was no significant difference in gender, age, weight and operation time between the three groups (P> 0.05). MAP in each group was significantly lower than that before operation (P <0.05). Between the three groups, MAP had no significant difference before, during and after operation. The lowest intraoperative HR and lowest SpO2 in each group were significantly lower than those before and after surgery (P <0.05), but the decline was transient and returned to normal quickly. The lowest HR and the lowest SpO2 in group P were significantly lower than those in the other two groups (P <0.05). There was no significant difference between the other two groups. Intraoperative propofol dosage P group was significantly more with the other two groups. The awake time of P + S group was significantly shorter than that of the other two groups (P <0.05). The incidence of intraoperative physical activity in group P (31%) was significantly higher than that in group P + F (6%) and group P + S (6%). The incidence of apnea was no significant difference among the three groups. P group was significantly lower than the other two groups. Conclusion Propofol combined with fentanyl or sufentanil for painless gastroscopy anesthesia is a safe and effective method, especially the compound sufentanil anesthesia more stable, perfect, safe, it is worth promoting.