Patient Controlled Sedation with Low Dose of Propofol and Sufentanil in Colonoscopy_West China Medical Journal

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1. Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu 610041,China;

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Keywords：

舒芬太尼; 异丙酚; 自控镇静镇痛; 结肠镜

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目的:观察舒芬太尼复合异丙酚自控镇静镇痛在结肠镜检查中的效果及不良反应,从而探讨该方法的安全性和有效性。方法:行无痛纤维结肠镜检查的患者60例,随机分为两组:自控镇痛/镇静组和静脉复合全麻醉组,每组30例。自控镇痛/镇静组首先缓慢静脉注射舒芬太尼0.12 μg/kg,随之接电子自控镇痛泵,负荷量设定为0.5 mg/kg,以4 mg/kg·h的速度持续泵入异丙酚(10 mg/mL),术中按压1次自控手柄可快速推注异丙酚1 mL。静脉复合全麻醉组首先静脉缓慢推注芬太尼1 μg/kg,咪唑安定0.02 mg/kg, 2 min后缓慢推注异丙酚0.8～1 mg/kg。术中间断给予异丙酚以维持听觉诱发电位指数(AAI)于30～40之间。结果:静脉复合全麻醉组的MAP较检查前明显下降且较自控镇痛/镇静组下降更为明显且具有统计学意义(P lt;0.05)。自控镇痛/镇静组的呼吸频率较静脉复合全麻醉组下降明显且在T3时间点具有统计学意义(P lt;0.05)。自控镇痛/镇静组患者OAA/S评分达5分和Aldrete评分达9分的时间均较静脉复合全麻醉组明显缩短(1.4±1.3 VS 3.9±1.7和 2.9±1.7 VS 5.7±1.7)(P lt;0.05)。两组的内镜医师和患者满意度评分无统计学差异(P＞0.05)。结论:自控镇静镇痛能够比传统的静脉全身麻醉提供更良好的循环系统稳定性,更迅速的麻醉后恢复,是结肠镜检查镇静镇痛的理想和安全方法。

Citation： SONG Huayong,LI Junxiang,Liu juan,WANG Xiao,et al. Patient Controlled Sedation with Low Dose of Propofol and Sufentanil in Colonoscopy. West China Medical Journal, 2009, 24(4): 898-901. doi: Copy

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1. WILLIAMS CB. Comfort and quality in colonoscopy [J]. Gastrointest Endsoc, 1994,40:769-70..
2. CHERNIK D A, GILLINGS D, LAINE H, et al. Validity and reliability of the Observer’s assessment of Alertness/Sedation Scale: study with intravenous midazolam[J]. J Clin Psychopharmacol,1990,10:244-251..
3. ALDRETE A. The post-anesthesia recovery score revisited[J]. J Clin Anaesth, 1995,8:415-421..
4. SUMPELMANN R, BUSING H, SCHRODER D, REKERSBRINK M, KROHN S, STRAUSS JM. Patient-controlled analgesia with clonidine and piritramide[J]. Anaesthesist, 1996,45:88-94..
5. MURKIN JM. Sufentanil anesthesia for major surgery: the multicentre Canadian clinical trial[J]. Can J Anaesth,1989,36(3):343-349..
6. NELSON D B, FREEMAN M L, SILVISSE, et al. A randomized, controlled trial of transcutaneous cardon dioxide monitoring during ERCP[J]. Gastrointest Endosc,2000,51:288-295..
7. DOI M, GAJRAJ RJ, MANTZARIDIS H, KENNY GNC. Prediction of movement at laryngeal mask airway insertion: comparison of auditory evoked potential index, bispectral index, spectral edge frequency and median frequency[J]. Br J Anaesth, 1999,82:203-207.

West China Medical Journal

Patient Controlled Sedation with Low Dose of Propofol and Sufentanil in Colonoscopy

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