卢剑华, 孙宜萍, 陈强. 咪达唑仑联合丙泊酚麻醉在老年患者内镜下逆行胰胆管造影术中的应用[J]. 蚌埠医学院学报, 2012, 36(3): 306-308.
    引用本文: 卢剑华, 孙宜萍, 陈强. 咪达唑仑联合丙泊酚麻醉在老年患者内镜下逆行胰胆管造影术中的应用[J]. 蚌埠医学院学报, 2012, 36(3): 306-308.
    LU Jian-hua, SUN Yi-ping, CHEN Qiang. Application of midazolam combined with propofol on endoscopic retrograde cholangiopancreatography procedure in elder patients[J]. Journal of Bengbu Medical College, 2012, 36(3): 306-308.
    Citation: LU Jian-hua, SUN Yi-ping, CHEN Qiang. Application of midazolam combined with propofol on endoscopic retrograde cholangiopancreatography procedure in elder patients[J]. Journal of Bengbu Medical College, 2012, 36(3): 306-308.

    咪达唑仑联合丙泊酚麻醉在老年患者内镜下逆行胰胆管造影术中的应用

    Application of midazolam combined with propofol on endoscopic retrograde cholangiopancreatography procedure in elder patients

    • 摘要: 目的:观察咪达唑仑联合丙泊酚麻醉在老年患者内镜下逆行胰胆管造影术(endoscopic retrograde cholangiopancreatography,ERCP)中的效果和安全性。方法:52例急诊行ERCP检查和治疗的老年患者,采用咪达唑仑联合丙泊酚麻醉,按10-8-6方案输注丙泊酚,先以负荷量咪达唑仑0.02 mg/kg及丙泊酚1 mg/kg,静脉输注时间;20 s,诱导剂量后以10 mgkg-1h-1的速率静脉输注丙泊酚,10 min后减为8 mgkg-1h-1,20 min后减为6 mgkg-1h-1直至术毕,以维持丙泊酚血浆靶浓度约为3g/ml。记录给药前、给药后1 min、内镜插入食管、停药、苏醒期5个时点的收缩压、舒张压、心率、血氧饱和度和各阶段时程以及术中不良反应情况,术后调查遗忘率和满意度。结果:给药后各时点收缩压与给药前差异均无统计学意义(P;0.05)。给药后1 min至清醒时舒张压均下降(P;0.05~P;0.01)。术中心率和血氧饱和度均无明显变化(P;0.05)。患者均有顺行性遗忘,总遗忘率为100.00%,总满意度达98.08%。结论:咪达唑仑联合丙泊酚麻醉适用于老年患者急诊ERCP,是一种较为安全有效的方法。

       

      Abstract: Objective:To observe the sedation and analgesic effects and safety of midazolam with propofol in endoscopic retrograde cholangiopancreatography(ERCP) for elder patients.Methods:Fifty-two elder patients were received midazolam plus propofol for sedation during diagnostic and therapeutic ERCP emergency procedure.The infusion scheme for a target blood propofol concentration of about 3 g/ml,which was according to 10-8-6 programme,consisting of a loading dose of 1 mg/kg of propofol combined with 0.02 mg/kg of midazolam,loading dose over 20 seconds followed immediately by an infusion of 10 mgkg-1h-1 of propofol for 10 minutes;8 mgkg-1h-1 for the next 10 minutes and 6 mgkg-1h-1 thereafter.The observing parameters including systolic blood pressure(SBP),diastolic blood pressure(DBP),heart rate(HR),SPO2 were recorded on five time points:before infusion,1 minute after infusion,esophagoscope introducing,stop infusion and recovery period.The lasting time on every stage as well as side effects,satisfaction of the procedure were assessed.Results:SBP had no difference on each time point after infusion than before infusion(P0.05).Compared with before infusion,DBP was decreased significantly on the other time points before recovery(P0.05-P0.01).HR and SPO2 were not changed on each time point(P0.05).Anterograde amnesia was appeared in all cases and the total rate of amnesia was 100%.The total rate of patients satisfaction was 98.08%.Conclusions:Midazolam combined with propofol represents a safe and effective sedation technique for elder patients in emergency case of ERCP.

       

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