小剂量瑞芬太尼复合丙泊酚静脉诱导用于无痛胃镜和无痛结肠镜检查的麻醉效果观察

摘要

Objective To explore the anesthetic effect of low dose remifentanil in patients undergoing sequential painless gastroscopy and painless colonoscopy in accordance with intravenous induction of propofol. Methods From July 2017 to January 2018,86 patients who needed painless gastroscopy and painless colonoscopy in sequence were selected as observation objects in the Second Hospital of Jiaxing and were divided into control group and observation group according to random number table method,with 43 cases in each group.The control group was anesthetized with propofol only,while the observation group was anesthetized with low dose remifentanil in accordance with propofol.The occurrence of adverse reactions and recovery were compared between the two groups.Results The incidence rate of adverse reactions of the control group was 20.93% (9/43),which of the observation group was 13.95% (6/43),there was no statistically significant difference between the two groups (χ2 =0.272,P=394).The recovery time and the observation time after awakening in the observation group were (7.19 ± 1.98)min and (6.94 ± 2.04)min,respectively,which were significantly shorter than those in the control group [(10.33 ± 2.42) min and (11.69 ± 3. 21 ) min], the differences were statistically significant ( t = 6. 585, 8. 190, P = 0. 000, 0. 000 ). Conclusion Intravenous induction with low dose remifentanil combined with propofol in patients undergoing painless gastroscopy and painless colonoscopy in sequence has less adverse reactions,good anesthesia persistence and short recovery time,which is worthy of clinical popularization.%目的 探究使用小剂量瑞芬太尼复合丙泊酚静脉诱导在行无痛胃镜和无痛结肠镜检查中的麻醉效果.方法 选取嘉兴市第二医院于2017年7月至2018年1月需行无痛胃镜和无痛结肠镜检查术的患者86例作为观察对象,按照随机数字表法分为对照组与观察组各43例.对照组患者仅采用丙泊酚麻醉,观察组患者采用小剂量瑞芬太尼复合丙泊酚进行麻醉.比较两组患者检查完毕后的不良反应发生情况以麻醉作用的起效、消失时间.结果 对照组不良反应发生率为20.93% (9/43),观察组为13.95% (6/43),差异无统计学意义(χ2 =0.272,P=394);观察组的苏醒时间以及醒后留观时间分别为(7.19 ± 1.98)min、(6.94 ± 2.04)min,明显短于对照组的(10.33 ± 2.42)min、(11.69 ± 3.21)min,差异均有统计学意义( t=6.585、8.190, P=0.000、0.000).结论 患者行无痛胃镜和无痛结肠镜的检查中使用小剂量瑞芬太尼复合丙泊酚静脉诱导具有不良反应少、麻醉持续性佳、苏醒时间短的优点,具有临床推广价值.