瑞芬太尼在老年高血压患者清醒状态无痛肠镜检查中的应用

Clinical Observation of Remifentanil Anesthesia in Sober Painless Colonal Endoscope for Elder Suffered Hypertension Disease

关键词:  瑞芬太尼  老年高血压  清醒  无痛肠镜

Key words:  remifentanil  elder hypertension  sober  painless colonal endoscope

摘要:

目的 探讨小剂量瑞芬太尼复合丙泊酚麻醉用于老年高血压患者清醒状态下无痛肠镜检查的安全性、可控性、可行性。方法 回顾性分析60例Ⅰ~Ⅲ级老年高血压低、中危患者，ASAⅡ~Ⅲ级，分为瑞芬太尼复合丙泊酚无痛肠镜组(Ⅰ组，n=30)，芬太尼复合丙泊酚无痛肠镜组(Ⅱ组，n=30)，统计患者检查前、检查中、检查后各时点监测指标，评估清醒程度、调查患者不适反应及满意率。结果 Ⅰ、Ⅱ组检查中各时点及监测值对比无显著性差异(P>0.05)；各组内检查前与检查中对比，SBP、DBP、HR、RR均有显著性差异(P<0.05)；各组检查后各项监测指标均接近检查前水平，无显著性差异(P>0.05)；检查后清醒、计算及提问对答、离室观察时间，Ⅰ组较Ⅱ组明显缩短，有显著性差异(P<0.05)；两组患者不适反应无显著性差异(P>0.05)，满意率均为100%。结论 小剂量瑞芬太尼复合丙泊酚麻醉在老年高血压患者中施行无痛肠镜检查，检查中患者处于清醒状态、循环稳定、安全可行。

Abstract:

OBJECTIVE To evaluate the clinical security, controllability and feasibility of remifentanil anesthesia combining propofol in painless colonal endoscope for elder suffered hypertension. METHODS Sixty elder accepted painless colonal endoscope(hypertension graded I-III, low risk to moderate risk, ASA graded II-III) were retrospectively randomized into two groups: remifentanil anesthesia combining propofol group(group I, n=30) and fentanil anesthesia combining propofol group(group II, n=30). The inspective dates of different timing points were calculated, patients consciousness degree and satisfaction was evaluated. RESULTS The inspective dates of both groups in each timing point have no significant difference(P>0.05), SBP, DBP, HR and RR before examination showed significant difference compared with the date during the examination in each group(P<0.05), dates after examination have no significant difference with these pre examination(P>0.05). The time of recovery and observation in group I was much shorter than that in group II(P<0.05). Discomfortable reaction in both groups has no significant difference(P<0.05). CONCLUSION Low dose of remifentanil anesthesia combining propofol in painless colonal endoscope for elder suffered hypertension are safety and feasible with steady circulation and quickly recovery.