不同药物预注射对胃镜检查中丙泊酚注射痛发生率及剂量的影响

摘要

目的:探讨不同药物预注射对胃镜检查中丙泊酚注射痛发生率及剂量的影响.方法:将2014年10月至2016年11月在广东省农垦中心医院接受胃镜检查的200例患者随机分为对照组(直接注射丙泊酚)、观察1组(预注射舒芬太尼)、观察2组(预注射利多卡因)、观察3组(预注射舒芬太尼+利多卡因),每组50例.比较麻醉前、后4组血氧饱和度(SpO2)、心率(HR)、平均动脉压(MAP)水平、疼痛评分、术后清醒时间、丙泊酚总应用剂量、不良反应发生率情况.结果:麻醉前,4组SpO2、HR、MAP水平比较,差异无统计学意义(P＞0.05);麻醉后5 min,4组HR、MAP均低于麻醉前,且对照组变化更为明显,分别与观察1组、观察2组、观察3组比较,差异均有统计学意义(均P＜0.05).4组疼痛评分比较,差异有统计学意义(P＜0.05),观察3组疼痛评分低于对照组、观察1组、观察2组,差异有统计学意义(P＜0.05).4组术后清醒时间、丙泊酚总应用剂量比较,差异有统计学意义(P＜0.05),且观察1组、观察2组、观察3组术后清醒时间、丙泊酚总应用剂量少于对照组,差异有统计学意义(P＜0.05);观察3组术后清醒时间、丙泊酚总应用剂量少于观察1组、观察2组,差异有统计学意义(P＜0.05).观察1组、观察2组、观察3组躁动、呕吐、恶心发生率与对照组比较,差异无统计学意义(P＞0.05).结论:胃镜检查中预注射舒芬太尼及利多卡因可明显减少丙泊酚总应用剂量,减轻丙白酚注射痛,缩短术后清醒时间,且不会对血流动力学水平产生不利影响,安全性较高.%Objective:To investigate the effect of different drugs pre-injection on the incidence of propofol injection pain and the dosage of propofol in gastroscopy.Methods:From October 2014 to November 2016,200 patients underwent gastroscopy in our hospital were randomly divided into control group (direct injection of propofol),observation group 1 (pre-injection of sufentanil),observation group 2 (pre-injection of lidocaine),and observation group 3 (pre injection of sufentanil and lidocaine),50 cases in each group.Before and after anesthesia,blood oxygen saturation (SpO2),heart rate (HR),mean arterial pressure (MAP),pain score,awake time,propofol total dose,adverse reactions incidence were compared.Results:There was no significant difference in SpO2,HR and MAP among four groups before anesthesia (P＜0.05).The HR and MAP at 5 min after anesthesia were lower than those before anesthesia in all groups,and the change was more significant in control group compared with observation group 1,observation group 2 and observation group 3.The pain scores among four groups were significant different (P＜0.05).The pain score of the observation group 3 was lower than those of the control group,observation group 1 and observation group 2 (P＜0.05).The differences in awake time,total propofol application dosage among four groups were also significant (P＜0.05),and those in observation group 1,2 and 3 were lower than that of the control group,and in observation group 3 was lower than those in observation group 1 and 2 (P＜0.05).There were no significant differences in the incidence of agitation,vomiting and nausea among groups (P＞0.05).Conclusion:Pretreatment with sufentanil and lidocaine in gastroscopy could significantly reduce the total dosage of propofol,decrease the propofol injection pain and shorten awake time without adverse effects on hemodynamics.