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目的:探讨丙泊酚复合芬太尼或氯胺酮在老年人输尿管镜检术中的可行性及安全性。方法:K组30例,静脉麻醉药配伍为氯胺酮0.25 mg/kg,丙泊酚1.5 mg/kg;F组30例,静脉麻醉药配伍为芬太尼1μg/kg,丙泊酚1.5mg/kg,静脉缓慢推注(60 s)。比较两组疗效。结果:两组镇静镇痛优良率为100%。用药后2 min,F组收缩压与用药前比较有统计学差异(P<0.05);收缩压下降>基础值20%,F组16例,K组9例。血压下降>基础值25%,需用麻黄素升压者,F组7例,K组2例。两组均有短暂呼吸抑制,SpO2不同程度下降。两组丙泊酚用量,苏醒时间及不良反应无统计学差异。结论:两种方法均可满意完成老年输尿管镜检术。但需细心调控用药量及注药速度,配备适当的复苏设施和必要的急救药物,以提高麻醉的安全性。
Objective: To investigate the feasibility and safety of propofol combined with fentanyl or ketamine in ureteroscopy in the elderly. Methods: 30 patients in group K were treated with 0.25 mg / kg of ketamine and 1.5 mg / kg of propofol. Group F received 30 mg of fentanyl and 1.5 mg / kg of propofol Slow intravenous bolus injection (60 s). Compare the two groups curative effect. Results: The two groups of sedation analgesic excellent rate was 100%. The systolic blood pressure of group F was significantly lower than that before treatment (P <0.05) at 2 min after treatment. The systolic blood pressure decreased by> 20% of basal value, 16 in group F and 9 in group K. Blood pressure drop> 25% of the base value, required ephedrine boost, F group 7 cases, K group 2 cases. Both groups had brief respiratory depression, SpO2 decreased to varying degrees. The two groups of propofol dosage, recovery time and adverse reactions no significant difference. Conclusions: Both methods are satisfactory for elderly ureteroscopy. However, careful control of drug dosage and injection speed, with the appropriate recovery facilities and necessary emergency medicine to improve the safety of anesthesia.