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目的观察小儿肠镜检查中应用丙泊酚联合芬太尼静脉麻醉的有效性、安全性及对呼吸循环的影响。方法 84例拟行肠镜检查或治疗的患儿,随机分为使用丙泊酚联合芬太尼的A组及采用单纯丙泊酚的B组,各42例。观察两组诱导丙泊酚用量、不同时点心率(HR)、呼吸率(RR)、平均动脉压(MAP)、血氧饱和度(SpO2),入睡和清醒时间、术中体动发生率;OAA/S评分;循环、呼吸变化和对操作记忆。结果两组麻醉诱导时的丙泊酚用量、麻醉手术时间、躁动率、肠镜检查成功率和呼吸抑制率比较,差异具有统计学意义(P<0.05),两组患儿术中OAA/S评分、初醒时间差异无统计学意义(P>0.05);B组在麻醉后1、3 min比麻醉前MAP有明显下降(P<0.05);所有患儿检查,治疗后对于手术过程均无记忆。结论丙泊酚联合芬太尼静脉麻醉用于小儿肠镜检查术,在密切的监护下和完善的抢救措施下是安全可行的。
Objective To observe the effectiveness, safety and effects of propofol combined with fentanyl intravenous anesthesia on the respiratory cycle in pediatric enteroscopy. Methods Totally 84 children undergoing colonoscopy or treatment were randomly divided into group A with propofol plus fentanyl and group B with pure propofol, 42 cases in each group. The levels of propofol, HR, respiratory rate (RR), mean arterial pressure (MAP), oxygen saturation (SpO2), sleep and wakefulness, OAA / S score; circulatory, respiratory changes and memory of the operation. Results There was significant difference in propofol dosage, time of anesthesia operation, agitation rate, success rate of colonoscopy and respiration rate between the two groups (P <0.05). The OAA / S (P> 0.05). The MAP in group B was significantly lower than that before anesthesia 1,3 min after anesthesia (P <0.05). No significant difference was found in the scores of all patients between the two groups memory. Conclusion Propofol and fentanyl intravenous anesthesia for pediatric colonoscopy, with close supervision and complete rescue measures is safe and feasible.