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目的探讨异丙酚复合瑞芬太尼用于膀胱镜检查的可行性和安全性。方法选择120例男性膀胱镜检查术患者,随机分为两组,A组为镇痛组,B组为对照组。A组患者术前两分钟左右注入异丙酚1.0-1.5mg/kg+瑞芬太尼1ug/kg,待病人睫毛反射消失后改维持量(异丙酚5-8mg/kg.·+瑞芬太尼6-12μg/kg·h),术中维持BIS于60-80之间,手术结束前1分钟停止给药。B组给予相当量的生理盐水作为对照。记录麻醉前、手术开始5分钟、15分钟、手术结束5分钟无创血压(NBP),氧饱和度(SPO_2),心率(HR),呼吸(R)和脑电双频指数(BIS)数值。意识状态采用OAAS评分。结果A组患者手术开始后5min、15min收缩压及手术开始后5min舒张压与麻醉前比较有非常显著性差异(p<0.01),手术开始后15min舒张压和手术开始后5min、15min心率有显著性差异(p<0.05)。麻醉手术结束后各项生命体征迅速恢复,手术结束5min时与术前无显著性差异(p>0.05)。各时段氧饱和度无明显变化(p>0.05)。B组患者血压心率均有一定程度地升高,但无统计学意义。A组术中BIS维持在55-82之间,手术开始后5min、15min与基础值T0相比有非常显著差异(p<0.01)手术结束5min即恢复,与T0比无差异(p>0.05)。B组BIS无明显变化。结论将异丙酚和瑞芬太尼用于膀胱镜检查,是一种安全有效的方法。。
Objective To investigate the feasibility and safety of propofol combined with remifentanil for cystoscopy. Methods A total of 120 male cystoscopy patients were selected and randomly divided into two groups. Group A was analgesic group and group B was control group. In group A, propofol 1.0-1.5mg / kg + remifentanil 1ug / kg was infused for about two minutes before surgery, and the amount of propofol 5-8mg / kg · · + Ni 6-12μg / kg · h), intraoperative BIS to maintain between 60-80, 1 minute before the end of surgery to stop dosing. B group was given a considerable amount of saline as a control. Record the values of NBP, SPO_2, HR, BIR and BIS at 5 minutes, 15 minutes and 5 minutes after the start of anesthesia. Consciousness using OAAS score. Results The systolic blood pressure at 5 min and 15 min and the diastolic blood pressure at 5 min after the start of operation in group A were significantly different from those before anesthesia (p <0.01). Diastolic blood pressure at 15 min after the start of operation and heart rate at 5 min and 15 min after the start of operation were significantly Sex differences (p <0.05). After the end of anesthesia, all the vital signs recovered rapidly. There was no significant difference between preoperative and postoperative 5min (p> 0.05). There was no significant change in oxygen saturation at each time point (p> 0.05). Blood pressure and heart rate in group B were increased to a certain extent, but not statistically significant. The intraoperative BIS was maintained between 55 and 82. There was a significant difference (P <0.01) between the baseline and the baseline T0 after 5 min and 15 min of operation. There was no significant difference between the two groups (P> 0.05) . BIS group B no significant change. Conclusion Propofol and remifentanil for cystoscopy is a safe and effective method. .