摘要
目的:探讨瑞马唑仑联合阿芬太尼与丙泊酚联合舒芬太尼在无痛胃肠镜检查中的应用效果。方法:以2023年8月—2024年10月我院收治的78例无痛胃肠镜检查患者为观察对象,采用随机数字表法分为观察组和对照组各39例。对照组采用舒芬太尼联合丙泊酚麻醉干预,观察组采用瑞马唑仑联合阿芬太尼麻醉干预。比较两组患者麻醉诱导时长、苏醒时长、离室时长、不同时刻血流动力学水平及检查前后镇静镇痛效果、应激反应水平、不良反应发生情况。结果:观察组麻醉诱导时长、苏醒时长、离室时长分别为(3.19±0.65)min、(6.83±1.25)min、(25.17±4.19)min,均短于对照组(P<0.05)。观察组在进镜即刻(T_(1))、操作开始后5 min(T_(2))、检查结束时(T_(3))的平均动脉压(MAP)、心率(HR)、脑电双频指数(BIS)均高于对照组(P<0.05)。检查后,观察组VAS评分为(2.36±0.63)分,低于对照组,Ramsay镇静评分为(2.65±0.67)分,高于对照组(P<0.05);观察组肾上腺素(E)为(36.31±5.78)ng/mL、去甲肾上腺素(NE)为(64.42±7.89)ng/mL、皮质醇(Cor)为(108.28±10.76)ng/mL,均低于对照组(P<0.05)。观察组不良反应发生率为10.26%,对照组不良反应发生率为7.69%,两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:瑞马唑仑联合阿芬太尼在无痛胃肠镜检查中的应用效果良好,能够缩短麻醉起效时间,有助于患者苏醒及减少血流动力学的 波动,有良好的镇痛及镇静效果,检查后患者应激反应较小,安全性良好。
Objective:To explore the application effect of remifentanil combined with fentanyl and propofol combined with sufentanil in painless gastroscopy.Methods:78 patients who underwent painless gastroscopy in our hospital from August 2023 to October 2024 were selected as the observation subjects.They were randomly divided into an observation group and a control group,with 39 patients in each group,using a random number table method.The control group received sufentanil combined with propofol anesthesia intervention,while the observation group received remifentanil combined with fentanyl anesthesia intervention.Compare the duration of anesthesia induction,awakening time,release time,hemodynamic levels at different times,sedative and analgesic effects before and after examination,stress response levels,and incidence of adverse reactions between two groups of patients.Results:The induction time,recovery time,and release time of anesthesia in the observation group were(3.19±0.65)minutes,(6.83±1.25)minutes,and(25.17±4.19)minutes,respectively,which were shorter than those in the control group(P<0.05).The mean arterial pressure(MAP),heart rate(HR),and bispectral index(BIS)of the observation group were higher than those of the control group at the time of endoscopic examination(T_(1)),5 minutes after the start of the operation(T_(2)),and at the end of the examination(T_(3))(P<0.05).After examination,the VAS score of the observation group was(2.36±0.63)points lower than that of the control group,and the Ramsay sedation score was(2.65±0.67)points higher than that of the control group(P<0.05);The levels of adrenaline(E),norepinephrine(NE),and cortisol(Cor)in the observation group were(36.31±5.78)ng/mL,(64.42±7.89)ng/mL,and(108.28±10.76)ng/mL,respectively,all lower than those in the control group(P<0.05).The incidence of adverse reactions in the observation group was 10.26%,while the incidence of adverse reactions in the control group was 7.69%.There was no statistically significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:The application of remifentanil combined with fentanyl in painless gastroscopy has a good effect,which can shorten the onset time of anesthesia,help patients recover and reduce hemodynamic fluctuations,and has good sedative and analgesic effects.The patient's stress response after examination is small and the safety is good.
作者
李富辉
张月玲
LI Fuhui;ZHANG Yueling(Department of Anesthesiology,The Fifth People's Hospital of Qinghai,810007)
出处
《青海医药杂志》
2025年第6期1-5,共5页
Qinghai Medical Journal
