目的 比较舒芬太尼和地佐辛应用于无痛胃镜检查麻醉的临床效果。方法 根据不同麻醉方案,采用随机数字表法将180例门诊行无痛胃镜患者随机分为3组,A组(舒芬太尼组):舒芬太尼0.1 μg/kg+丙泊酚;B组(地佐辛组):地佐辛70 μg/kg+丙泊酚;C组(对照组):生理盐水+丙泊酚。观察并记录3组患者注药至睫毛反射消失时间,胃镜检查时间,丙泊酚总用量,麻醉前后MAP、HR、SPO₂,术中呼吸暂停次数及麻醉苏醒期恶心、呕吐、头晕不良反应发生率。结果 注药至睫毛反射消失时间A组(90.3±8.2) s、B组(95.3±9.1)s和C组(125.7±7.3)s比较,A组时间明显缩短,差异有统计学意义(P<0.05);丙泊酚用量A组(63.1±9.2)mg、B组(70.4±5.9)mg和C组(89.3±6.4)mg比较,用药量明显减少,差异有统计学意义(P<0.05);B组麻醉苏醒期恶心、头晕发生率(20.0%;21.7%)较A组(1.7%;8.3%)和C组(0.0%;1.7%)明显增高,差异有统计学意义(P<0.05)。结论 舒芬太尼联合丙泊酚用于无痛胃镜检查麻醉效果更好,不良反应发生率更低,是无痛胃镜治疗安全有效的麻醉方案。

Objective To compare the clinical effect of sufentanil and dezocine in painless gastroscopy.Methods 180 cases of outpatients who had been examined by painless gastroscopy were randomly divided into three groups: group A (sufentanil 0.1 g/kg+ propofol), group B (dezocine 70 g/kg+ propofol), and group C (control group, saline + propofol). The time taken by the loss of eyelash reflex after injection, the total dosage of propofol, preoperative and postoperative MAP, HR and SPO₂, intraoperative apnea and the incidence of such adverse reactions as nausea, vomiting, dizziness during the recovery from anesthesia in the three groups were observed and recorded.Results The time taken by the loss of eyelash reflex after injection was(90.3±8.2)s in group A, (95.3±9.1)s in group B and (125.7±7.3)s in group C. The dosage of propofol was(63.1±9.2)mg in group A, (70.4±5.9)mg in group B and (89.3±6.4)mg in group C. The dosage was significantly reduced (P<0.05)in group A. The incidence of nausea, vomiting and dizziness was 20.0% and 21.7% respectively in group B, much higher than in group A (1.7% and 8.3%) and in group C (0.0% and 1.7%) (P<0.05).Conclusions Sufentanil combined with propofol has a better effect of anesthesia in painless gastroscopy, with fewer adverse reactions.This is a safe and effective treatment scheme for painless gastroscopy.