[1]尧永华,邬子林.瑞芬太尼复合丙泊酚静脉麻醉用于老年患者结肠镜检查的临床观察[J].南方医科大学学报,2005,(06):715-717.
 YAO Yong-hua,WU Zi-lin.Clinical investigation of total intravenous anesthesia with remifentanil and propofol for colonoscopy in the elderly[J].,2005,(06):715-717.
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瑞芬太尼复合丙泊酚静脉麻醉用于老年患者结肠镜检查的临床观察()
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《南方医科大学学报》[ISSN:/CN:]

卷:
期数:
2005年06期
页码:
715-717
栏目:
出版日期:
2005-06-01

文章信息/Info

Title:
Clinical investigation of total intravenous anesthesia with remifentanil and propofol for colonoscopy in the elderly
作者:
尧永华1 邬子林2
1. 广州市肿瘤医院麻醉科, 广东, 广州, 510095;
2. 广州市第一人民医院麻醉科, 广东, 广州, 510180
Author(s):
YAO Yong-hua1 WU Zi-lin2
1. Department of Anesthesiology, Tumor Hospital of Guangzhou, Guangzhou 510095, China; 2. Department of Anesthesiology, First People’s Hospital of Guangzhou, Guangzhou 510180, China
关键词:
瑞芬太尼丙泊酚芬太尼门诊手术老年人
Keywords:
remifentanilpropofoloutpatient operationthe elderly
分类号:
R614.42
摘要:
目的 观察瑞芬太尼复合丙泊酚用于老年患者结肠镜检的麻醉效果及安全性。方法 选择结肠镜检查老年病人30例,随机均分为瑞芬太尼(R)组与芬太尼(F)组。R组用微量泵输注瑞芬太尼0.05μg/kg·min给药;F组单次给芬太尼1μg/kg。1min后所有病人静脉注射负荷量丙泊酚0.4mg/kg,继以缓慢间断推注每次0.2mg/kg,至RamsayⅢ-Ⅳ级。记录诱导、插镜、苏醒及留观时间;记录各时点平均动脉压、心率、脉搏氧饱和度及呼吸频率;记录术中肢动、呼吸暂停、头晕乏力、恶心呕吐、胸肌强直次数;记录病人满意度。结果 R组病人的诱导、清醒、留观时间均显著少于F组(P<0.05)。丙泊酚用于R组显著少于F组(P<0.05),术中R组的平均动脉压下降低于F组(P<0.05)。术中肢动R组少于F组,呼吸抑制R组大于F组,但无显著性差异。病人的满意度R组高于F组。结论 静脉微量泵注瑞芬太尼复合丙泊酚麻醉效果确切、安全,是老年病人门诊检查的麻醉选择方法之一,术中应注意瑞芬太尼的给药速度,加强呼吸监护与管理。
Abstract:
Objective To evaluate the efficacy and safety of intravenous anesthesia with remifentanil and propofol for colonoscopy in the elderly. Methods Thirty old patients scheduled for colonoscopy were randomly allocated into remifentanil group and fentanyl group. Those in group remifentanil received remifentanil at the dose of 0.05 μg/kg·min with micropump, while those in group F were given a bolus injection of fentanyl at 1 μg/kg intravenously. One minute later, all the patients were given a loading dose of propofol of 0.4 mg/kg followed by boluses of propofol (0.2 mg/kg) administered intermittently until Ramsay sedation scale Ⅲ-Ⅳ. The induction time of anesthesia, intubation time of colonoscope, time of recovery from anesthesia and stay in the postanesthesia care unit (PACU) were recorded. The mean arterial pressure (MAP), heart rate (HR), pulse oxygen saturation (SpO2) and respiratory rate (RR) were measured and recorded with noninvasive monitoring. The lower limb movement, apnea, dizziness, body weakness, nausea and vomiting, and chest wall rigidity were recorded during operation. All the patients were reviewed for satisfaction after the operation. Results The time of anesthesia induction, intubation time of colonoscope, time of recovery from anesthesia and stay in PACU in remifentanil group were shorter than those in fentanyl group (P<0.05), and propofol consumption was significantly less in the former group (P<0.05). Greater MAP decrement was observed in remifentanil group (P<0.05). Fewer patients had lower limb movement while more had respiratory depression in remifentanil group than in fentanyl group. The rate of patient-rated satisfaction was significantly higher in remifentanil group (P<0.05). Conclusion Intravenous anesthesia with remifentanil and propofol for colonoscopy is safe and reliable, which can be a good alternative for anesthesia in outpatient operation for the elderly.

参考文献/References:

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[6] Wilhelm W, Schlaich N, Harrer J, et al. Recovery and neurological examination after remifentanil-desflurane of fenanyl-desflurane anaesthesia for carolid artery surgery[J]. Br J Anaesth, 2001, 86(1):44-9.
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备注/Memo

备注/Memo:
收稿日期:2005-1-11。
作者简介:尧永华(1971- ),男,主治医师,主要从事临床麻醉以及疼痛诊疗工作
更新日期/Last Update: 1900-01-01