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目的观察异丙酚复合瑞芬太尼用于胃镜检查的镇痛效果和对呼吸、循环及上消化道蠕动的影响。方法 90例需行胃镜检查患者,分为3组:P组、R1组和R2组,每组各30 例。P组异丙酚剂量为3 mg/kg;R1组异丙酚剂量为1．5 mg/kg,瑞芬太尼为0．6μg／kg;R2组异丙酚剂量为2．0mg／kg,瑞芬太尼为0．8μg／kg。结果 3组镇痛效果无明显差异(P>0．05)。R1组和R2 组异丙酚用量明显少于P组(P<0．05),苏醒时间明显短于P组(P<0．05)。R1组术中SBP、DBP、 HR、SpO2及上消化道蠕动程度与P组相比差异无统计学意义(P>0．05)。R2组术中SBP、DBP、HR 与P组相比差异也无统计学意义(P>0．05),诱导后5min时SpO2降低较P组和R1组明显(P<0．05), 术中上消化道蠕动程度明显强于P组和R1组(P<0．05)。结论异丙酚1．5 mg／kg复合瑞芬太尼 0．6μg／kg应用于胃镜检查,麻醉镇痛效果好,异丙酚用量少,对呼吸和循环的抑制轻,上消化道蠕动强度弱,苏醒时间短。
Objective To observe the analgesic effects of propofol combined with remifentanil for gastroscopy and the effects on respiratory, circulatory and upper gastrointestinal motility. Methods Ninety patients underwent gastroscopy were divided into three groups: group P, group R1 and group R2, with 30 in each group. Propofol dose was 3 mg / kg in group P, propofol dose was 1.5 mg / kg in R1 group, and 0.6 μg / kg in remifentanil group, 2.0 mg / kg in R2 group, Remifentanil was 0.8 μg / kg. Results There was no significant difference in analgesic effect between the three groups (P> 0.05). The dosage of propofol in group R1 and group R2 was significantly less than that in group P (P <0.05), and the awakening time was significantly shorter than that in group P (P <0.05). The SBP, DBP, HR, SpO2 and upper gastrointestinal motility in group R1 were not significantly different from those in group P (P> 0.05). There were no significant differences in SBP, DBP and HR between group R2 and group P (P> 0.05). The decrease of SpO2 in group R2 was more significant than group P and group R1 (P <0.05) The degree of peristalsis in upper gastrointestinal tract was significantly higher than those in group P and group R1 (P <0.05). Conclusions Propofol 1.5 mg / kg and remifentanil 0.6 μg / kg are suitable for gastroscopy. The anesthetic analgesic effect is good, the dosage of propofol is less, the respiration and circulation are less inhibited, the upper gastrointestinal motility Weak strength, short recovery time.