异丙酚静脉麻醉3种输注方式对无痛肠镜效果和安全性的比较

目的 观察无痛肠镜异丙酚静脉麻醉3种输注方式的效果及安全性.方法 120例行无痛肠镜的患者随机分为手控组、微泵组和靶控组3组,每组40例,分别采用异丙酚静脉麻醉3种不同输注方式.观察指标有:诱导时间、镜检时间、苏醒时间、总检查时间、异丙酚麻醉诱导用药量和总用药量,镜检不同时间点的HR、RR、MAP、SpO2及并发症的发生率.结果 靶控组诱导时间和苏醒时间均明显短于手控组和微泵组(P＜0.01),麻醉诱导用药量在3组间差异无统计学意义(P＞0.05),但异丙酚总用药量靶控组明显低于手控组和微泵组(P＜0.01或0.05);给药1min时,手控组和微泵组的FIR、RR、MAP、SpO2较给药前均有明显下降(P＜0.01),而靶控组仅MAP和SpO2较给药前明显下降(P＜0.01);靶控组、微泵组和手控组并发症发生率分别为17.5%、22.5%和37.5%,靶控组明显低于手控组(P＜0.05).结论 靶控输注麻醉诱导快、苏醒快、能维持平稳的麻醉深度,并可减少麻醉药用量和并发症发生率.

Efficacy and safety of three modes of intravenous propofol infusion in painless enteroscopy

Objective To observe the efficacy and safety of three modes of intravenous propofol infusion in patients undergoing painless enteroscopy.Methods A total of 120 patients receiving painless enteroscopy were randomly divided into three groups,accepted manual control,minipump and target controlled infusion of propofol,respectively.The time of induction,enteroscopy,recovery and total examination,the induction and total dosage of propofol,and HR,RR,MAP,SpO2 and complication were recorded.Results The time of induction and recovery and total dosage in target controlled group was obviously lower than that in other groups(P<0.01-0.05).There were no significant difference in induction dosage among three groups(P>0.05).HR,RR,MAP and SpO2 in manual control and minipump groups,and MAP and SpO2 in target controlled group decreased significantly 1 miniute after infusion(P<0.01).The complication rate in manual control group was superior to that in target controlled group(37.5% vs 17.5%,P<0.05).Conclusion Target controlled infusion of propofol is a safe and effective anesthesia for painless enteroscopy.