地佐辛和芬太尼在老年人无痛胃镜检查中的应用比较

摘要

Objective:To compare the clinical effects and safety of dezocine and fentany in elderly patients undergoing painless endoscopy. Method:One hundred elderly patients undergoing painless endoscopy were randomly divided into dezocine group(group D,n=50)and fentany group (group F,n=50).Group D was given dezocine 0.05 mg/kg and Group F was given fentany 1 μg/kg,then two group of patients,respectively,after the interval of 4 minutes and 1 minutes were given propofol 1-2 mg/kg,the endoscopy were performed after the eyelash reflex disappeared.Heart rate(HR), mean arterial pressure(MAP),saturation of peripheral oxygen(SpO2)were recorded before anesthesia,two minutes after anesthesia and awakening. Recorded the sum of propofol,operating time,awakening time,the ramsay and adverse reactions in two groups.Result:The levels of HR MAP and SpO2 of two groups during endoscopy were decreased(P<0.05),while the level of SpO2 of group F during endoscopy were lower than group D(P<0.05).the sum of propofol,operating time and awakening time showed no significant difference between two groups(P>0.05),but the Ramsay of group D was lower than group F,and there were fewer adverse reactions in group D(P<0.05).Conclusion:0.05 mg/kg dezocine is more suitable for the elderly patients than 1μg/kg fentany,it has exact effect of anesthesia,less respiratory depression,higher level of consciousness awakening and fewer adverse reactions.%　　目的：研究对比地佐辛和芬太尼用于老年人无痛胃镜检查的麻醉效果和临床安全性。方法：将行无痛胃镜检查的老年患者100例随机分为地佐辛组（D 组，n=50）和芬太尼组（F 组，n=50），D 组患者静脉注射地佐辛0.05 mg/kg，F 组患者静脉注射芬太尼1μg/kg，之后两组患者分别间隔4 min 和1 min 开始静脉注射丙泊酚1~2 mg/kg，至患者睫毛反射消失后开始做胃镜检查。记录两组患者用药前，用药后2 min，苏醒时的 HR、MAP、SpO2，记录两组患者丙泊酚总用量、手术时间、唤醒时间、苏醒时镇静评分以及麻醉期间的不良反应等。结果：两组患者用药后2 min 的 HR、MAP、SpO2均较注药前下降明显（P<0.05），且 F 组患者用药后2 min 的 SpO2低于 D 组（P<0.05）。两组患者丙泊酚总用量、手术时间、唤醒时间组间比较差异无统计学意义（P>0.05），但 D 组患者苏醒时镇静评分低于 F 组，麻醉期间的不良反应少（P<0.05）。结论：0.05 mg/kg 地佐辛复合丙泊酚相比较1μg/kg 芬太尼复合丙泊酚更适用于老年人无痛胃镜检查，麻醉效果确切，呼吸抑制减少，苏醒时清醒程度高，且不良反应少。