两种麻醉方案在行无痛胃镜老年患者中的效果比较

摘要

目的 比较两种麻醉方案在行无痛胃镜老年患者中的效果.方法 纳入医院内镜中心行无痛胃痛检查的老年患者900例,依据麻醉方案不同将其分为观察组(n=500,采用依托咪酯+瑞芬太尼麻醉方案)和对照组(n-=400,采用丙泊酚+瑞芬太尼麻醉方案),比较两组麻醉一般情况,分别于检查前10 min (T0)、检查中10 min(T1)、检查后10 min (T2)测定平均动脉压(MAP)、心率(HR)、血氧饱和度(SpO2)、呼吸频率,观察麻醉期间不良反应.结果 观察组麻醉诱导时间短于对照组(P＜0.05);T1时观察组MAP、SpO2高于对照组,T2时观察组MAP、HR也较对照组高(P＜0.05);观察组总不良反应和低氧血症发生率低于对照组(P＜0.05).结论 与丙泊酚复合瑞芬太尼相比,依托咪酯复合瑞芬太尼用于老年无痛胃镜检查,可减少对呼吸循环系统的影响,不良反应轻,麻醉诱导时间短,值得在临床推广应用.%Objective To compare the effects of two anesthesia schemes for the senile patients undergoing painless gastroscopy.Methods A total of 900 senile patients undergoing painless stomachache examination in our hospital were divided into an observation group (n=500,etomidate + remifentanil anesthesia scheme) and a control group (n=400,propofol + remifentanil anesthesia scheme) according to different anesthesia schemes.The general situations of anesthesia were compared between the two groups;the mean arterial pressure (MAP),heart rate (HR),oxygen saturation (SpO2) and respiratory frequency were measured 10 min (T0) before the examination,after 10 min (T1) since the examination,and 10 min (T2) after the examination.The adverse reactions were observed during the anesthesia.Results The anesthesia induction time in the observation group was shorter than that in the control group (P ＜0.05);at T1,the MAP and SpO2 of the observation group were higher than those of the control group,and at T2,the MAP and HR of the observation group were also higher than those of the control group (P ＜ 0.05).The incidences of total adverse reaction and hypoxemia of the observation group were lower than those of the control group (P ＜ 0.05).Conclusion Compared with propofol plus remifentanil,etomidate combined with remifentanil used for senile painless gastroscopy can reduce the influence on respiratory and circulatory system,with light adverse reaction and short induction time of anesthesia.It is worth popularizing in clinical application.