[1]李文燕,张澍田,冀明,等.胃镜检查时丙泊酚最佳初始剂量的随机对照研究[J].中国微创外科杂志,2005,05(12):1052-1054.
　LiWenyan,ZhangShutian,JiMing,et al.Optimal initial dose of Propofol sedation in gastroscopy: A randomized controlled study[J].Chinese Journal of Minimally Invasive Surgery,2005,05(12):1052-1054.
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胃镜检查时丙泊酚最佳初始剂量的随机对照研究()
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《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
05
期数:
2005年12期
页码:
1052-1054
栏目:
出版日期:
2005-12-30

文章信息/Info

Title:
Optimal initial dose of Propofol sedation in gastroscopy: A randomized controlled study
作者:
李文燕; 张澍田; 冀明; 吴咏冬; 于中麟
首都医科大学附属北京友谊医院消化内科,北京市消化疾病中心,北京,100050
Author(s):
LiWenyan;  ZhangShutian;  JiMing;  et al.
Department ofGastroenterology, BeijingFriendshipHospital ofCapitalUniversity ofMedicalSciences, Beijing100050, China
关键词:
镇静胃镜; 丙泊酚; 脑电双频指数
Keywords:
Sedative gastroscopy; 　Propofo; l　Bispectral index
分类号:
R573;R614
文献标志码:
A
摘要:
目的探讨丙泊酚用于胃镜镇静的最佳初始剂量.方法接受无痛胃镜检查67例为镇静组,按随机数字表随机分为3组,丙泊酚首次剂量不同:A组(n=22)1.0 mg/kg;B组(n=23)1.5 mg/kg;C组(n=22)2.0 mg/kg.普通胃镜检查20例为对照组.于丙泊酚给药后1 min进镜,当病人出现不良反应且影响操作时追加丙泊酚20～30 mg.监测血压、心率、血氧饱和度值(SpO2)、脑电双频指数(BIS),以BIS值反应镇静深度.结果进镜时各组BIS值差异有显著性(F=33.31,P=0.000),C组BIS值为(53.82±9.52),镇静深度最深,处于麻醉状态,B组BIS值为(64.52±8.30),接近镇静状态.首次剂量下各组无须追加给药,顺利进镜率B(65.2%,15/23)、C(86.4%,19/22)组高于A组(31.8%,7/22)(x2=5.020,13.538;P=0.025,0.000),B、C组间无差异(x2=2.722,P=0.099).3个镇静组给药后血压、心率均下降,对照组血压、心率均升高.检查中平均动脉压变化量C组高于其他3组(P＜0.05);心率变化量对照组最高,3个镇静组间差异无显著性.SpO2＜90%的发生率,C组(68.2%,15/22)明显高于A组(27.3%,6/22)和B组(34.8%,8/23)(x2=7.379,5.020;P=0.007,0.025),A、B组间差异无显著性(x2=0.296,P=0.586).结论丙泊酚1.5 mg/kg作为胃镜检查的首次剂量进镜效果好且安全.
Abstract:
Objective　To investigate the optimal initial dose ofPropofol sedation in gastroscopy.　M ethods　A total of 87 patients undergoing upper gastrointestinal endoscopywere divided into 4 groups according to a random number table. Propofol sedation was intravenously administrated at an initialdose of1. 0 mg/kg (GroupA, n=22), 1. 5 mg/kg (Group B, n=23), and 2. 0 mg/kg (Group C, n=22), respectively. The ControlGroup (n=20) underwenta routine unsedated diagnostic gastroscopy. The gastroscopy started 1 min after the administration of Propofo.l A bonus of 20~30 mg Propofolwas given during the procedure when necessary. Patients'blood pressure, heart rate, blood oxygen saturation (SpO2), and the bispectral index (BIS) weremonitored and recorded.　 Results　Significant difference was recorded in BIS values among the four groups when introducing the endoscope (F=33·31, P=0·000). Patients of theGroup C (BIS, 53·82±9·52) had the deepest sedation andwere in narcosis, while patients of theGroup B (BIS, 64·52±8·30) were in sedation. The rates ofno need forbonus Propofolwere higher in theGroup B (65·2%, 15/23) and the Group C (86·4%, 19/22) than in the Group A (31·8%, 7/22) (χ2=5·020,13·538; P=0·025, 0·000) but were not significantly differentbetween theGroup B and theGroup C (χ2=2·722, P=0·099). The blood pressure and the heart rate decreased after intravenous administration of Propofol in the Group A~C, while increased in the ControlGroup. The fluctuation of the mean artery pressurewas the highest in theGroup C (P<0·05). The changes ofheart ratewere the greatest in the ControlGroup andwere not significantly differentamong theGroupA, B, and C. The rates ofSpO2<90% were significantly higher in theGroup C (68·2%, 15/22) than in the Group A (27·3%, 6/22) and the Group B (34·8%, 8/23) (χ2=7·379 and 5·020;P=0·007 and 0·025), butwere not significantly different between the Group A and B (χ2=0·296, P=0·586).　Conclusions　Intravenous Propofol sedation at an initial dose of1. 5 mg/kg for upper gastrointestinal endoscopy is effective and safe.

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更新日期/Last Update: 2014-04-29