国际麻醉学与复苏杂志   2012, Issue (3): 7-7
    
丙泊酚不同输注方式用于80岁以上老年人无痛结肠镜检查的比较
周桥灵1()
1.中山大学附属佛山医院
Different infusion methods of propofol in the anesthesia for the aged more than 80 years during painless colonoscopy
 全文:
摘要:

目的 探讨丙泊酚靶控输注(target controlled infused,TCI) 、持续输注与手控推注在80岁以上老年人无痛肠镜检查术中的临床效果与副作用,为临床选择麻醉方式提供参考。方法 120例患者按完全随机法分为:TCI组(Ⅰ组)、持续输注组(Ⅱ组)、手控推注组 (Ⅲ组),每组各40例。监测患者入室后、 插镜时、进镜达末端回肠或回盲部时、睁眼时的心率(HR)、平均动脉压(MBP)、脉搏血氧饱和度(SpO2);诱导、注药、入镜、苏醒时间;记录丙泊酚总用药量、副作用和操作者满意度等。 结果 全部患者均完成肠镜检查,成功率100%。3组患者一般情况及各时点生命体征比较无统计学差异。3组的诱导时间为(40+-6)、(58+-10)、(58+-8)s;苏醒时间为(3.7+-1.3)、(5.0+-1.8)、(6.9+-1.7)min。TCI组的诱导时间及苏醒时间较其他两组明显缩短(P<0.05)。3组丙泊酚总量为(91+-11)、(110+-14)、(131+-16)mg。Ⅲ组患者高于其他两组(P<0.05)。注药时间、入镜时间及输液量3组差异无统计学意义。Ⅲ组的操作者满意率最低,Ⅰ组最高,为100%。Ⅰ组患者麻黄素使用率低于其他两组(P<0.05),副作用发生例数最少。 结论 TCI、持续输注及手控推注丙泊酚均可安全用于80岁以上患者行无痛肠镜检查,其中TCI更有优势。

关键词: 老年人,80岁以上;无痛肠镜;丙泊酚;靶控输注
Abstract:

Objective To investigate the results of three formula of anesthesia management of propofol in the aged more than 80 years during colonoscopy. Methods 120 aged patients >80 years scheduled to undergo painless colonoscopy,were randomly divided into three groups,GroupⅠ、GroupⅡand GroupⅢ,each group 40 patients.Patients in GroupⅠreceived target controlled infusion of propofol and in GroupⅡreceived continuous infused propofol by vein pump, While patients in GroupⅢ received manual controlled infused propofol.MBP、ECG、HR、SpO2% were recorded before colonoscopy, during and after colonoscopy. Anesthetic induction time, length of colonoscopy time,total propofol dosage, recovery time, side effects and satisfaction were also recorded. Results All patients had finished colonoscopy safely. There is no difference about MBP、ECG、HR and SpO2% among the three groups. The anesthetic induction time were(40+-6),(58+-10),(58+-8)s,respectively.The recovery time were(3.7+-1.3),(5.0+-1.8),(6.9+-1.7)min,respectively.The total propofol dosage were(91+-11),(110+-14),(131+-16)mg,respectively.In GroupⅠ,lower propofol dosage was recorded, anesthetic induction time and recovery time were shorter than these in GroupⅡand GroupⅢ.The side effects were the least in GroupⅠand its satisfaction was the best. Conclusion It is satisfactory in aged more than 80 years to administer propofol with different administration ways during colonoscopy . Target controlled infusion(TCI)of propofol may be the better way for the anesthesia of the aged during painless colonoscopy.

Key words: The aged>80 years; Painless colonoscopy; Propofol; Target controlled infusion