两种麻醉方法用于内镜下微量射频术的效果观察

Effect of two different anesthesia methods in GERD patients for radiofrequency treatment

摘要:

目的??比较两种麻醉方法用于胃食管反流（GERD）患者内镜下微量射频治疗的麻醉效果及安全性。方法?选择内镜下微量射频治疗的GERD患者80例，随机分为右美托嘧啶+依托咪酯+舒芬太尼（DES）组和异丙酚+咪达唑仑+芬太尼（PMF）组。记录患者给药前（T0）、给药后（T1）、胃镜检查开始（T2）、射频治疗开始（T3）、射频治疗5 min（T4）、10 min（T5）及治疗结束（T6）时的收缩压（SBP）、舒张压（DBP）、心率（HR）、脉搏氧饱和度（SpO2）和呼吸频率（RR）；观察并记录手术时间、清醒时间、操作反应、药物追加、不良反应发生情况、麻醉效果及医生和患者满意度。结果?与麻醉前比较，两组患者给药后HR、SpO2、SBP、DBP和RR均有下降，治疗过程中变化不显著，但DES组变化更加平稳。两组患者手术时间、清醒时间差异无统计学意义，DES组患者操作反应少于PMF组，且治疗中药物追加明显减少。DES组患者呼吸幅度大影响操作及注射痛等不良反应发生少于PMF组，其中PMF组2例诱发哮喘发作终止治疗。DES组麻醉效果及医生、患者满意度均优于PMF组。结论?GERD患者微量射频治疗使用右美托嘧啶、依托咪酯、舒芬太尼麻醉更加安全有效，且使用方便，更好的满足了手术需求。

Abstract:

Objective?To observe the safety and efficacy of two different anesthesia methods in GERD (Gastroesophageal reflux disease) patients for radiofrequency treatment. Methods?Eighty GERD patients for radiofrequency treatment were randomly divided into the Dexmedetomidine-Etomidate-Sufentanil group (group DES) and the Propofol-Midazolam-Fentanil group (group PMF). SBP, DBP, HR, SpO2 and RR were recorded at different times. Operating time, awaking time, operant response, the dose of anesthetics, the adverse reactions, the anesthesia effect and the satisfaction were recorded as well. Result?After anesthesia, SBP, DBP, HR, SpO2 and RR were lower in both groups. There were no significant differences during the therapeutic process, but the changes were more stable in group DES. There were no significant differences in the operating time and awaking time in both groups. The operant response and the dose of anesthetics were less in group DES than that in group PMF. The case of preventing operation and injection pain were less in group DES than that in group PMF. In group PMF, 2 cases were stopped therapy because of asthmatic attack. The anesthesia effect and the satisfaction in group DES were better than that in group PMF. Conclusion?Dexmedetomidine, Etomidate and Sufentanil can be used safer and more effective in GERD patients for radiofrequency treatment.