【摘要】 目的对比不同血浆靶控浓度丙泊酚复合瑞芬太尼在无痛胃肠镜检查中的应用效果。方法将行胃肠镜检查的400例患者随机分为R0、R1、R2、P0组,分别给予丙泊酚3.0、2.0、1.5、0μg/ml及复合瑞芬太尼0、0.5、1.0、2.0ng/ml。监测无创血压、心率、心电图、脉搏和血氧饱和度,分别记录患者意识消失时间和恢复时间,并记录术中体动情况和术后主观感觉评分。结果R1、R2组患者意识恢复时间明显短于R0组(P<0.05)。R0、R1组患者主观感觉评分明显优于R2、P0组(P<0.05)。结论丙泊酚与瑞芬太尼在胃肠镜检查中合用具有协同作用,但作用机制不同。以血浆靶控浓度2.0μg/ml丙泊酚复合0.5ng/ml瑞芬太尼效果最佳。更多还原

【Abstract】 Objective To compare the effects of target-controlled infusion (TCI) of Propofol plus Remifentanil in different doses for patients undergoing painless gastrointestinal endoscopy.Methods Four hundred patients,aged from 24 to 85,undergoing painless gastrointestinal endoscopy were randomly divided into four groups: group R0,R1,R2,P0.They were respectively given Propofol with concentration of 3.0,2.0,1.5,0 μg/ml plus Remifentanil with concentration of 0,0.5,1.0,2.0 ng/ml,until they lost consciousness.We monitored the noninvasive blood pressure,heart rat,cardiogram,pulse and oxygen saturation.The time required for loss of consciousness by TCI of Propofol and Remifentanil (TLOC),and for recovery of consciousness (TROC) were recorded.Ramsay score and subject emotional experience score were also assessed.Results TROCs were significantly shorter in group R1 and R2 than that in group R0 ( P <0.05).Subjective emotional experience scores were better in group R0,R1 than those in group R2 and P0 ( P <0.05).Conclusion Propofol and Remifentanil have different effective mechanisms,but they are synergic when given by TCI simultaneously for painless gastrointestinal endoscopy.The best target effect compartment concentrations are Propofol 2.0 μg/ml plus Remifentanil 0.5 ng/ml.更多还原