老年无痛胃镜检查中地佐辛和瑞芬太尼的比较分析
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摘要
目的探讨老年无痛胃镜检查中地佐辛和瑞芬太尼麻醉效果的比较。方法 80例无痛胃镜检查老年患者,随机分为地佐辛组(D组)和瑞芬太尼组(R组),每组40例。D组患者静脉注射地佐辛和丙泊酚;R组患者静脉注射瑞芬太尼和丙泊酚。观察两组患者术中心率(HR)、呼吸频率(RR)、平均动脉压(MAP)以及血氧饱和度(SpO_2)变化,比较两组苏醒时Ramsay镇静(RSS)评分以及呼吸抑制、恶心呕吐、体动等不良反应。结果两组患者HR在麻醉诱导后(T2)时较麻醉诱导前(T1)时显著下降(P<0.05);两组患者T2时HR比较差异无统计学意义(P>0.05)。T2时两组RR比较差异无统计学意义(P>0.05)。T2时两组患者的MAP、SpO_2较T1时均明显下降(P<0.05),但T2时D组患者的MAP、SpO_2较R组下降缓和,差异有统计学意义(P<0.05)。D组患者出体动例数1例明显少于R组的7例,差异有统计学意义(P<0.05);D组患者苏醒时RSS评分为(2.5±0.3)分,低于R组的(3.7±0.7)分(P<0.05)。结论与瑞芬太尼复合丙泊酚相比,地佐辛复合丙泊酚在老年人无痛胃镜检查中麻醉效果确切,血流动力稳定,苏醒时清醒程度高,不良反应少,可以安全用于临床。
Objective To investigate the anesthesia effect of dezocine and remifentanil in examination of painless gastroscopy. Methods A total of 80 senile patients with painless gastroscopy were randomly divided into dezocine group(group D) and remifentanil group(group R), with 40 cases in each group. Group D received intravenous injection of dezocine and propofol, and group R received intravenous injection of remifentanil and propofol. Observation were made on intraoperative heart rate(HR), respiratory rate(RR), mean arterial pressure(MAP), and oxygen saturation(SpO_2) changes in two groups, and comparison were made on Ramsay sedation score(RSS) during recovery, adverse reactions of respiratory depression, nausea, vomiting, and body motion in two groups. Results Both groups had obviously declined HR after anesthesia induction(T2) than before anesthesia induction(T1)(P<0.05). Both groups had no statistically significant difference in HR at T2(P>0.05). Both groups had no statistically significant difference in RR at T2(P>0.05). Both groups had obviously decreased and relieved MAP and SpO_2 at T2 than at T1(P<0.05). At T2, group D had lower MAP and SpO_2 than group R, and their difference was statistically significant(P<0.05). Group D had obviously less number of body motions as 1 case than 7 cases in group R, and the difference was statistically significant(P<0.05). Group D had lower RSS during recovery as(2.5±0.3) points than(3.7±0.7) points in group R(P<0.05). Conclusion Compared with remifentanil combined with propofol, dezocine combining with propofol shows affirmative anesthesia effect in senile patients with painless gastroscopy, with stable hemodynamics, high degree of sobriety during recovery and fewer adverse reactions. It can be safely applied in clinic.
Objective To investigate the anesthesia effect of dezocine and remifentanil in examination of painless gastroscopy. Methods A total of 80 senile patients with painless gastroscopy were randomly divided into dezocine group(group D) and remifentanil group(group R), with 40 cases in each group. Group D received intravenous injection of dezocine and propofol, and group R received intravenous injection of remifentanil and propofol. Observation were made on intraoperative heart rate(HR), respiratory rate(RR), mean arterial pressure(MAP), and oxygen saturation(SpO_2) changes in two groups, and comparison were made on Ramsay sedation score(RSS) during recovery, adverse reactions of respiratory depression, nausea, vomiting, and body motion in two groups. Results Both groups had obviously declined HR after anesthesia induction(T2) than before anesthesia induction(T1)(P<0.05). Both groups had no statistically significant difference in HR at T2(P>0.05). Both groups had no statistically significant difference in RR at T2(P>0.05). Both groups had obviously decreased and relieved MAP and SpO_2 at T2 than at T1(P<0.05). At T2, group D had lower MAP and SpO_2 than group R, and their difference was statistically significant(P<0.05). Group D had obviously less number of body motions as 1 case than 7 cases in group R, and the difference was statistically significant(P<0.05). Group D had lower RSS during recovery as(2.5±0.3) points than(3.7±0.7) points in group R(P<0.05). Conclusion Compared with remifentanil combined with propofol, dezocine combining with propofol shows affirmative anesthesia effect in senile patients with painless gastroscopy, with stable hemodynamics, high degree of sobriety during recovery and fewer adverse reactions. It can be safely applied in clinic.
引文
[1]敖程斌,黄月红,胡战兵.右美托咪定与丙泊酚联用于老年患者无痛胃镜麻醉的临床观察.中国药师,2016,19(2):306-307.
[2]王晓玲,胡霁.无痛胃镜应用于老年患者常见并发症及安全性探讨.现代消化及介入诊疗,2016,21(3):477-479.
[3]陶方,罗昌春,曹艳红.高龄老年高血压患者无痛胃镜检查过程中生命体征的变化.医学临床研究,2015(3):461-462.
[4]高雁良.联合用药在超高龄患者无痛胃镜检查中的应用研究.山西医药杂志,2016,45(21):2542-2544.
[5]文华海,冉锐,田江涛.不同剂量丙泊酚麻醉对接受无痛胃镜检查老年患者认知功能的影响.河北医学,2017,23(4):589-594.
[6]褚天,樊友凌,黄雁,等.丙泊酚-瑞芬太尼靶控输注联合右美托咪定用于老年患者无痛胃镜检查的临床研究.中国当代医药,2015(11):104-106.
[7]刘志伟.无痛胃镜对老年患者的影响.中国实用医药,2011,6(22):105-106.
[8]周攀科,兰志勋.地佐辛用于术后镇痛的研究进展.实用医院临床杂志,2011,21(6):2811-2813.
[9]安卫平,徐炳欣,张亚飞,等.地佐辛联合丙泊酚在老年患者无痛胃镜检查中的临床观察.中国临床研究,2015,28(5):611-613.
[10]王科擎.丙泊酚分别复合瑞芬太尼和地佐辛在门诊无痛胃镜中的应用.中外健康文摘,2014(15):122-123.
[2]王晓玲,胡霁.无痛胃镜应用于老年患者常见并发症及安全性探讨.现代消化及介入诊疗,2016,21(3):477-479.
[3]陶方,罗昌春,曹艳红.高龄老年高血压患者无痛胃镜检查过程中生命体征的变化.医学临床研究,2015(3):461-462.
[4]高雁良.联合用药在超高龄患者无痛胃镜检查中的应用研究.山西医药杂志,2016,45(21):2542-2544.
[5]文华海,冉锐,田江涛.不同剂量丙泊酚麻醉对接受无痛胃镜检查老年患者认知功能的影响.河北医学,2017,23(4):589-594.
[6]褚天,樊友凌,黄雁,等.丙泊酚-瑞芬太尼靶控输注联合右美托咪定用于老年患者无痛胃镜检查的临床研究.中国当代医药,2015(11):104-106.
[7]刘志伟.无痛胃镜对老年患者的影响.中国实用医药,2011,6(22):105-106.
[8]周攀科,兰志勋.地佐辛用于术后镇痛的研究进展.实用医院临床杂志,2011,21(6):2811-2813.
[9]安卫平,徐炳欣,张亚飞,等.地佐辛联合丙泊酚在老年患者无痛胃镜检查中的临床观察.中国临床研究,2015,28(5):611-613.
[10]王科擎.丙泊酚分别复合瑞芬太尼和地佐辛在门诊无痛胃镜中的应用.中外健康文摘,2014(15):122-123.