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目的:比较芬太尼或氨酚羟考酮辅助丙泊酚静脉全麻在老龄患者无痛结肠镜检查中的效果和安全性。方法:40例老龄患者随机分为2组,每组20例。芬太尼组患者静脉缓慢推注芬太尼0.5μg.kg-1,氨酚羟考酮组患者检查前1 h口服氨酚羟考酮1片,继而两组静脉推注丙泊酚1.0~1.5 mg.kg-1,观察患者麻醉深度为3~4级时停止给药。发现患者有轻微肢体活动后立即追加丙泊酚20~40 mg/次,检查中监测MAP,HR,SpO2,记录丙泊酚用量、检查时间、清醒时间、离院时间和清醒期不良反应。结果:芬太尼组在检查中MAP,HR和SpO2较用药前下降,且与氨酚羟考酮组有明显差异(P<0.01);两组患者检查时间及丙泊酚用量无明显差异,但是氨酚羟考酮组患者清醒时间和离院时间均比芬太尼组时间短,而且清醒期不良反应的例数少(P<0.05)。结论:氨酚羟考酮辅助丙泊酚对老龄患者无痛结肠镜检查效果好、安全性高。
OBJECTIVE: To compare the efficacy and safety of fentanyl or oxycodone for propofol intravenous anesthesia in painless colonoscopy in elderly patients. Methods: Forty elderly patients were randomly divided into two groups with 20 cases in each group. Fentanyl group intravenous infusion of fentanyl 0.5μg.kg-1, paracetamol and oxycodone patients 1h before taking an oral test of oxycodone, and then two groups of intravenous propofol 1.0 ~ 1.5 mg.kg-1, observe the depth of anesthesia in patients with grade 3 to 4 stop dosing. Patients were found to have mild physical activity immediately after the appendage of propofol 20 ~ 40 mg / time, check the MAP, HR, SpO2, record the amount of propofol, examination time, awake time, hospital stay and awake adverse reactions. Results: The levels of MAP, HR and SpO2 in the fentanyl group were significantly lower than those before the drug treatment and significantly different from those in the oxycodone group (P <0.01). There was no significant difference between the two groups in the examination time and the dosage of propofol, However, patients in the oxycodone group had shorter awake and out-of-hospital time than those in the fentanyl group, and had fewer cases of adverse reactions during awakening (P <0.05). Conclusion: Paracetamol and acetochlor do propofol for elderly patients with painless colonoscopy is effective and safe.