舒芬太尼复合咪达唑仑在清醒镇静结肠镜检查中的应用

张文强,邱小凤,梁郁等.舒芬太尼复合咪达唑仑在清醒镇静结肠镜检查中的应用[J].吉林医学,2013,34(30):6258-6260.

舒芬太尼；咪达唑仑；清醒镇静；结肠镜检查

张文强，邱小凤，梁 郁，李方卿

福建省三明市中西医结合医院麻醉科，福建 三明 365001

2013年

6258-6260

知网,万方

目的:探讨舒芬太尼复合咪达唑仑实施清醒镇静结肠镜检查的有效性和安全性.方法:将130例行实施结肠镜检查的患者随机分为S组(67例):舒芬太尼0.1～0.15 μg/kg加咪达唑仑0.04～0.06 mg/kg、C组(63例):实施常规结肠镜检查.观察和记录患者术前、术中、术后的Bp、HR、SpO2,术中Ramsay镇静分级,术后对术中疼痛评分(数字评分法NRS)和术中操作的记忆,以及对结肠镜检查的感受.结果:与C组比较,S组结肠镜检查时间缩短(P＜0.05);术中Ramsay镇静分级2～4级;术后对术中疼痛NRS评分低(P＜0.01),对操作无明显记忆(P＜0.01),术后感觉舒适(P＜0.01).术中血流动力学更平稳,在S组SBP、HR变化幅度均在正常范围内,而C组检查中收缩压及HR显著升高(P＜0.01).结论:舒芬太尼复合咪达唑仑用于结肠镜检查,患者清醒配合,无痛镇静,对操作无明显记忆,其血流动力学相对平稳,是安全、舒适、有效的. Objective To evaluate the effectiveness and safety of sufentanil and midazolam for conscious sedation for colonoscopy implementation.Methods Patients were randomly divided into 130 cases of the implementation of colonoscopy for the S group(67 cases):sufentanil 0.1～0.15 μ g/kg plus midazolam 0.04～0.06 mg/kg,C group(63 cases):the implementation of routine colonoscopy.Patients were observed and recorded before,during and after the operation,Bp,HR,SpO2,hierarchical Ramsay sedation,scoring on postoperative pain after operation(Digital score NRS) and the operation of the memory,and the experience of colonoscopy.Results Compared with C group,S group colonoscopy time was shortened(P＜0.05);Ramsay intraoperative sedation grade 2 to grade 4;postoperative pain in patients undergoing lower NRS score(P＜0.01),no memory of the operation(P＜0.01),postoperative comfort(P＜0.01).Intraoperative hemodynamics more stable,in group S,SBP,HR changes were in the normal range,while the C group check the systolic blood pressure and HR were significantly increased(P＜0.01). Conclusion Sufentanil combined with midazolam for colonoscopy in patients with painless,clear,calm,no memory of the operation,the relatively stable hemodynamics,is safe,comfortable,efficient.。