张华

[摘要] 目的 探究在老年无痛胃镜术中使用地佐辛复合丙泊酚进行麻醉的应用效果。 方法 随机选取2017年8月—2018年1月期间收入该院接受无痛胃镜术的患者120例作为研究对象进行研究，根据麻醉方式的不同分为对照组和观察组患者各60例，对照组患者使用丙泊酚麻醉，观察组患者采取地佐辛复合丙泊酚进行麻醉，对比两组患者的麻醉效果。 结果 观察组患者的丙泊酚用量和苏醒时间显著低于对照组（t=6.408、4.775，P<0.05），两组患者的意识消失时间和疼痛评分差异无统计学意义（t=0.025、0.036，P>0.05）；观察组患者的满意度显著高于对照组患者（χ2=3.394，P<0.05）；对照组患者不良反应发生率為6.67%，观察组为5.00%，两组相比差异无统计学意义（χ2=0.079，P>0.05）。 结论 对于老年患者的无痛胃镜术前麻醉，采用地佐辛联合丙泊酚麻醉的方式可以在降低患者清醒时间的同时稳定好患者的呼吸以及循环功能，值得临床参考。

[关键词] 地佐辛；丙泊酚；联合；老年无痛胃镜；效果

[中图分类号] R614 [文献标识码] A [文章编号] 1674-0742（2018）08（b）-0105-03

Dizocine and Propofol Anesthesia for Painless Gastroscopy in Elderly Patients

ZHANG Hua

Department of Anesthesiology， Third People's Hospital of Rugao， Rugao， Jiangsu Province， 226531 China

[Abstract] Objective To explore the effect of anesthesia with dizocine and propofol in elderly patients with painless gastroscopy. Methods A total of 120 patients who underwent painless gastroscopy in the hospital from August 2017 to January 2018 were random selected as study subjects. According to the different anesthesia methods， 60 patients were divided into each control group and observation group， and the control group adopted propofol anesthesia， patients in the observation group were treated with dizocine and propofol， and the anesthetic effects of the two groups of patients were compared. Results The propofol dose and wake-up time were significantly lower in the observation group than in the control group （t=6.408， 4.775， P<0.05）. There was no significant difference in the time of consciousness disappearance and pain score between the two groups （t=0.025， 0.036， P>0.05）； Satisfaction in the observation group was significantly higher than that in the control group （χ2=3.394， P<0.05）； The incidence of adverse reactions in the control group was 6.67%， in the observation group was the difference was statstically signficant 5.00%（χ2=0.079， P>0.05）. Conclusion For elderly patients with painless gastroscope preoperative anesthesia， the combination of dezocine and propofol anesthesia can reduce the patient's awakening time and stabilize the patient's breathing and circulatory function， which is worthy of clinical reference.

[Key words] Dezocine； Propofol； Combination； Elderly painless gastroscopy； Effect

无痛胃镜是一种在普通胃镜检查基础上注射麻醉剂进行短时间内的麻醉使患者进入镇静睡眠状态[1]，而后在患者无知觉的情况下使用胃镜完成检查，检查完毕后使患者迅速醒来的技术[2]。无痛胃镜的实施可以使得胃镜检查过程无痛苦，避免了患者因痛苦造成的机械损伤，有利于检查过程有效顺利进行[3]。而对于麻醉剂的选择临床上常用丙泊酚，但由于老年患者体质的特殊性，呼吸功能以及循环功能相对衰退[4]，恢复速度显著降低，因而对麻醉剂的选择要求对呼吸以及循环功能的影响尽可能。丙泊酚起效快[5]，但患者的呼吸和循环功能恢复较慢[6]，因而临床上很期待新的麻醉方式的产生来改善这一状况。……