笑气吸入与异丙酚静脉麻醉镇痛技术在结肠镜检查中的临床对比研究

摘要

目的 对比研究笑气吸入与异丙酚静脉麻醉镇痛技术在结肠镜检查中的临床应用价值.方法 接受结肠镜检查的180例患者,随机分为两组:其中自愿接受笑气吸入镇痛的90例为A组(笑气组),通过面罩吸入笑氧混合气(笑气浓度为45％～50％),自愿接受静脉麻醉的90例为B组(异丙酚组),选用手背静脉推注异丙酚2mg/kg.观察两组患者的镇痛效果、不良反应发生情况,监测检查前后不同时点的血压、心率和血氧饱和度,记录操作时间、离院时间,检查结束后问卷调查患者的主观意见反应.结果 A、B两组的镇痛效果、不良反应发生率、操作时间、满意率和愿意再接受检查率比较,差异均无显著性(P＞0.05).B组患者检查中血压、心率和血氧饱和度均较检查前下降(P＜0.05),A组患者离院时间明显短于B组(P＜0.01).结论 笑气吸入与异丙酚静脉麻醉应用于结肠镜检查均有良好的镇痛效果,笑气吸入镇痛技术操作简便、恢复迅速、安全可靠,而异丙酚静脉麻醉对呼吸、循环系统有一定的抑制作用.%[Objective] To compare the clinical application value of analgesia technique with nitrous oxide inhalation and propofol intravenous anesthesia in colonoscopy.[Methods] 180 patients undergoing colonoscopy were randomly divided into two groups:In Group A (nitrous oxide group),mixed gas (45～50 percent nitrous oxide and 50～ 55 percent oxygen) was inhaled during colonoscopy.In Group B (propofol group),propofol (2mg/kg) was intravenously injected before colonoscopy.Analgesic effect,adverse reactions of all patients were observed.Blood pressure,heart rate and oxygen saturation were monitored before,during and after colonoscopy.Operating time and recovery time were recorded.Patients' self-feelings were recorded by questionnaire survey after colonoscopy.[Results] There was no statistical significance in analgesic effect,adverse reaction incidence,operating time,satisfaction and re-acceptant rate between group A and group B (P ＞0.05).The blood pressure,heart rate and oxygen saturation during operating were decreased (P ＜0.05) compared with that of before operating in group B.The recovery time in group A was decreased significantly (P ＜0.01) compared with group B.[Conclusion] Both analgesia technique with nitrous oxide inhalation and propofol intravenous anesthesia have a good analgesic effect in colonoscopy.Analgesia technique with nitrous oxide inhalation is safe,feasible and easy to handle,and the patients recover rapidly.Propofol intravenous anesthesia could suppress the respiratory and circulation system in colonoscopy.