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目的了解异丙酚辅以阿托品静脉麻醉在60岁以上老年人无痛胃镜、结肠镜检中镇静、止痛效果。方法2004年2月～2007年3月我们采用异丙酚联合静脉麻醉下行无痛内镜诊疗共6445例,其中根据适应症,进行临床筛选,确定了825例60岁以上老年人行无痛胃、结肠镜检查,并观察操作时间、检查成功率、并发症以及检查前、中、后三个阶段的血氧饱和度、心率、平均动脉压。结果该组老年人无痛内镜操作时间(7.8±0.8)min、检查成功率达100%,病人满意率99.8%,80%病人注药后平均动脉压、心率、呼吸、血氧饱和度有不同程度下降(P<0.01),进行相应处理后均能顺利完成检查,另外患者出现注射部位疼痛、术后头晕、乏力等一般不需特别处理。结论异丙酚辅以阿托品静脉麻醉下进行老年人无痛胃镜、结肠镜检查成功率高,患者依从性好、无痛苦、乐意接受,该检查也是较安全的。
Objective To understand the sedation and analgesia effect of propofol supplemented with atropine intravenous anesthesia in painless gastroscopy and colonoscopy in the elderly over 60 years old. Methods February 2004 ~ March 2007 we use propofol combined with intravenous anesthesia painless endoscopic diagnosis and treatment of a total of 6445 cases, according to indications, clinical screening, identified 825 cases of 60 years of age were painless stomach, Colonoscopy, and observation of operation time, check the success rate, complications, and check before, during and after the three stages of oxygen saturation, heart rate, mean arterial pressure. Results The painless endoscopic operation time (7.8 ± 0.8) min in the elderly group was 100%, the satisfaction rate was 99.8%. Average arterial pressure, heart rate, respiration and oxygen saturation (P <0.01). After the corresponding treatment, they could successfully complete the examination. In addition, the patients showed pain in the injection site, dizziness and fatigue after the operation, and no special treatment was required. Conclusion Propofol supplemented with atropine intravenous anesthesia for elderly painless gastroscopy, high success rate of colonoscopy, patients with good compliance, no pain, willing to accept the test is also relatively safe.