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瑞芬太尼联合丙泊酚在清醒无痛消化内镜诊断结肠癌中的应用。

Application of remifentanil combined with propofol in the diagnosis of colon cancer with awakening painless digestive endoscopy.

作者信息

Xian Ailan, Wang Chunbin, Guo Ni, Wang Zaixing, Yang Lei, Gao Jie, Yang Longjun

机构信息

Department of Gastroenterology, Dongying People's Hospital, Dongying, Shandong 257091, P.R. China.

Department of Pharmacy, Dongying People's Hospital, Dongying, Shandong 257091, P.R. China.

出版信息

Oncol Lett. 2019 Feb;17(2):1589-1594. doi: 10.3892/ol.2018.9801. Epub 2018 Dec 6.

Abstract

Anesthetic effect of remifentanil combined with propofol in awakening painless endoscopy was analyzed. Retrospective analysis of 120 cases of colon cancer were treated in Dongying People's Hospital from June 2015 to December 2017. All of them were treated by awakening painless digestive endoscopy, divided into 60 cases in observation group (combined with remifentanil and propofol anesthesia), and 60 cases in control group (combined intravenous anesthesia of finanib and propofol). The data were respectively recorded at time-points of oxygen inhalation, intubation for 10 min, awakening time, waking time, and the time-points for each represented as the time-points of T1, T2, T3, T4, T5 and recorded the diastolic blood pressure (DBP), respiratory rate (RR) and heart rate (HR), and compared the awakening effect and the occurrence of adverse reaction. There was no significant difference in the DBP index between the two groups at time-point T1 (P>0.05). The time-points of T2, T3, T4 and T5 were significantly different from the observation group (P<0.05). There was no significant difference in RR index between the two groups and between the same groups (P>0.05). Compared with the control group, the awakening time and consciousness recovering of the observation group is lower (P<0.05). The incidence of adverse reactions after awakening operation between the two groups was statistically significant (P<0.05). The local pain rate in the observation group after the awakening operation was lower than the control group. The combined use of trace remifentanil and small dose propofol in the awakening painless digestive endoscopy can make the patients with colon cancer more stable when they are in the awakening state, so as to improve the safety of awakening painless digestive endoscopy. It is worth promoting in clinical practice.

摘要

分析瑞芬太尼联合丙泊酚在清醒无痛内镜检查中的麻醉效果。回顾性分析2015年6月至2017年12月在东营市人民医院治疗的120例结肠癌患者。所有患者均接受清醒无痛消化内镜检查,分为观察组60例(瑞芬太尼联合丙泊酚麻醉)和对照组60例(芬太尼联合丙泊酚静脉麻醉)。分别记录吸氧时、插管10分钟、苏醒时间、清醒时间等时间点的数据,各时间点分别表示为T1、T2、T3、T4、T5,并记录舒张压(DBP)、呼吸频率(RR)和心率(HR),比较苏醒效果及不良反应发生情况。两组在T1时间点DBP指标差异无统计学意义(P>0.05)。观察组T2、T3、T4、T5时间点与对照组差异有统计学意义(P<0.05)。两组间及同组内RR指标差异无统计学意义(P>0.05)。与对照组比较,观察组苏醒时间及意识恢复情况较低(P<0.05)。两组术后苏醒期不良反应发生率差异有统计学意义(P<0.05)。观察组术后苏醒期局部疼痛率低于对照组。在清醒无痛消化内镜检查中联合使用微量瑞芬太尼和小剂量丙泊酚可使结肠癌患者在苏醒状态时更稳定,从而提高清醒无痛消化内镜检查的安全性。值得在临床实践中推广。

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