以丙泊酚為麻醉劑的成人無痛胃鏡的臨床觀察_West China Medical Journal

Authors：

 劉鳳 ,  黃茂濤 , 胡海燕 , 曹亞玲 , 王平 , 毛本紅 , 史小英

解放軍第452醫院消化內分泌科（成都，610021）;

Corresponding?author：

黃茂濤, Email: mysterioussc@qq.com

Keywords：

丙泊酚; 胃鏡; 麻醉; 護理

DOI：

10.7507/1002-0179.20140283

Video：

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目的觀察單用丙泊酚作為短效麻醉劑的成人無痛胃鏡的安全性、有效性以及護理特點。方法選擇2010年1月－2011年12月，單用丙泊酚作為短效麻醉劑，進行無痛胃鏡檢查（不包括行鏡下治療的無痛胃鏡）患者5 180例，予麻醉劑量2～3 mg/kg，觀察術中患者生命體征、神志，有無嗆咳、躁動，胃鏡操作成功率，以及復蘇時間、患者滿意度、痛苦感、不良反應等。結果患者在靜脈注射丙泊酚后1～2 min麻醉成功，其中術中躁動203例，占3.9%；給予追加麻醉劑506例，占9.8%，追加劑量60～80 mg，所有患者均成功完成胃鏡檢查。患者在麻醉后8～10 min即可清醒自行走出復蘇室。術后訴感覺舒適愜意，無痛苦感。均未出現嚴重不良反應，清醒后無不良記憶，患者滿意度高。結論單用丙泊酚作為短效麻醉劑行無痛胃鏡檢查安全有效，胃鏡室配置專職麻醉師及術前、術中、術后精心專業護理是無痛胃鏡安全操作的重要保證。

Citation： 劉鳳, 黃茂濤, 胡海燕, 曹亞玲, 王平, 毛本紅, 史小英. 以丙泊酚為麻醉劑的成人無痛胃鏡的臨床觀察. West China Medical Journal, 2014, 29(5): 933-934. doi: 10.7507/1002-0179.20140283 Copy

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5.	王曉紅. 小劑量芬太尼復合異丙酚用于無痛胃鏡臨床觀察[J]. 河北醫藥, 2011, 33(2):224-225.
6.	Riphaus A, Geist F, Wehrmann T. Endoscopic sedation and monitoring practice in Germany:re-evaluation from the first nationwide survey 3 years after the implementation of an evidence and consent based National guideline[J]. Z Gastroenterol, 2013, 51(9):1082-1088.
7.	Fanti L, Agostoni M, Gemma M, et al. Sedation and monitoring for gastrointestinal endoscopy:a nationwide web survey in Italy[J]. Dig Liver Dis, 2011, 43(9):726-730.
8.	Cohen LB, Wecsler JS, Gaetano JN, et al. Endoscopic sedation in the United States:results from a nationwide survey[J]. Am J Gastroenterol, 2006, 101(5):967-974.
9.	Riphaus A, Lechowicz I, Frenz MB, et al. Propofol sedation for upper gastrointestinal endoscopy in patients with liver cirrhosis as an alternative to midazolam to avoid acute deterioration of minimal encephalopathy:a randomized, controlled study[J]. Scand J Gastroenterol, 2009, 44(10):1244-1251.
10.	Triantafillidis JK, Merikas E, Nikolakis D, et al. Sedation in gastrointestinal endoscopy:current issues[J]. World J Gastroenterol, 2013, 19(4):463-481.
11.	Oh JE, Lee HJ, Lee YH. Propofol versus midazolam for sedation during esophagogastroduodenoscopy in children[J]. Clin Endosc, 2013, 46(4):368-372.
12.	Wang D, Chen C, Chen J, et al. The use of propofol as a sedative agent in gastrointestinal endoscopy:a meta-analysis[J]. PLoS One, 2013, 8(1):e53311.
13.	Overley CA, Rex DK. A nursing perspective on sedation and nurse-administered propofol for endoscopy[J]. Gastrointest Endosc Clin N Am, 2004, 14(2):325-333.

1. 張樹兵, 任建剛. 1200例無痛胃鏡檢查治療體會[J]. 西南軍醫, 2007, 9(4):147-148.
2. 龐家武, 黃永昌, 蒙春霞. 無痛胃鏡126例臨床研究[J]. 華夏醫學, 2007, 20(6):1217-1219.
3. 李巖, 孟瑞霞. 麻黃堿與異丙酚、芬太尼配伍用于無痛胃鏡的臨床觀察[J]. 河南外科學雜志, 2007, 13(2):36-37.
4. 史文生, 吳小麗, 陳靜. 不同麻醉方法在無痛胃鏡檢查中的臨床觀察[J]. 臨床和實驗醫學雜志, 2011, 10(6):450-451, 453.
5. 王曉紅. 小劑量芬太尼復合異丙酚用于無痛胃鏡臨床觀察[J]. 河北醫藥, 2011, 33(2):224-225.
6. Riphaus A, Geist F, Wehrmann T. Endoscopic sedation and monitoring practice in Germany:re-evaluation from the first nationwide survey 3 years after the implementation of an evidence and consent based National guideline[J]. Z Gastroenterol, 2013, 51(9):1082-1088.
7. Fanti L, Agostoni M, Gemma M, et al. Sedation and monitoring for gastrointestinal endoscopy:a nationwide web survey in Italy[J]. Dig Liver Dis, 2011, 43(9):726-730.
8. Cohen LB, Wecsler JS, Gaetano JN, et al. Endoscopic sedation in the United States:results from a nationwide survey[J]. Am J Gastroenterol, 2006, 101(5):967-974.
9. Riphaus A, Lechowicz I, Frenz MB, et al. Propofol sedation for upper gastrointestinal endoscopy in patients with liver cirrhosis as an alternative to midazolam to avoid acute deterioration of minimal encephalopathy:a randomized, controlled study[J]. Scand J Gastroenterol, 2009, 44(10):1244-1251.
10. Triantafillidis JK, Merikas E, Nikolakis D, et al. Sedation in gastrointestinal endoscopy:current issues[J]. World J Gastroenterol, 2013, 19(4):463-481.
11. Oh JE, Lee HJ, Lee YH. Propofol versus midazolam for sedation during esophagogastroduodenoscopy in children[J]. Clin Endosc, 2013, 46(4):368-372.
12. Wang D, Chen C, Chen J, et al. The use of propofol as a sedative agent in gastrointestinal endoscopy:a meta-analysis[J]. PLoS One, 2013, 8(1):e53311.
13. Overley CA, Rex DK. A nursing perspective on sedation and nurse-administered propofol for endoscopy[J]. Gastrointest Endosc Clin N Am, 2004, 14(2):325-333.

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以丙泊酚為麻醉劑的成人無痛胃鏡的臨床觀察

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