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首页> 外文期刊>Canadian journal of anesthesia: Journal canadien d'anesthesie >Remifentanil is an effective alternative to propofol for patient-controlled analgesia during digestive endoscopic procedures
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Remifentanil is an effective alternative to propofol for patient-controlled analgesia during digestive endoscopic procedures

机译：瑞芬太尼是丙泊酚的有效替代品，可用于消化内镜手术过程中的患者自控镇痛

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PURPOSE: Unlike propofol, the self-administration of remifentanil for sedation in gastrointestinal endoscopies has never been evaluated formally. We wanted to compare the efficacy and tolerance of patient self-administration of remifentanil vs propofol during gastrointestinal endoscopy. METHOD: This prospective randomized, single-blinded study, included 77 patients undergoing gastrointestinal endoscopy. Patients were divided into two groups: group R received remifentanil (5 microg.kg(-1).hr(-1) infusion, 25 microg boli, refractory period of five minutes) and group P received propofol (2 mg.kg(-1).hr(-1) infusion, 0.5 mg.kg(-1) boli, refractory period of ten minutes). A 1 mg.kg(-1) bolus of propofol was administered before the procedure began in cases of marked anxiety. Additional boli of 25 microg of remifentanil or 0.5 mg.kg(-1) of propofol were administered when patients complained during the refractory period. The evaluation targeted analgesic efficacy during the procedure and patient satisfaction. The degree of sedation during the procedure and the occurrence of adverse reactions were analyzed. RESULTS: Patient satisfaction was high and comparable in both groups, with the number of awake and oriented patients being significantly higher in group R. Hemodynamic and respiratory tolerance was comparable in both groups, despite two episodes of desaturation in group R. The incidence of nausea was significantly higher in group R. CONCLUSIONS: The self-administration of remifentanil for sedation during gastrointestinal endoscopies is as effective as the self-administration of propofol and can be offered to patients, especially when it is desirable that they remain conscious during the procedure.
机译：目的：与丙泊酚不同，瑞芬太尼在胃肠道内镜检查中用于镇静的自我给药从未得到正式评估。我们想比较瑞芬太尼与丙泊酚在胃肠道内窥镜检查期间患者自我给药的疗效和耐受性。方法：这项前瞻性随机单盲研究包括77例接受胃肠道内窥镜检查的患者。患者分为两组：R组接受瑞芬太尼（5 microg.kg（-1）.hr（-1）输注，25 microg玻利，不应期为五分钟），P组接受丙泊酚（2 mg.kg（-） 1）.hr（-1）输注，0.5 mg.kg（-1）玻利，不应期为10分钟）。在出现明显焦虑的情况下，在开始手术前先给予1 mg.kg（-1）的异丙酚大剂量。当患者在难治期间抱怨时，再服用25微克瑞芬太尼或0.5 mg.kg（-1）异丙酚。该评估针对手术过程中的镇痛效果和患者满意度。分析了手术过程中的镇静程度和不良反应的发生。结果：两组患者的满意度均很高，并且相当，R组中清醒和定向患者的数量显着更高。尽管R组中出现了两次脱饱和，但两组的血流动力学和呼吸耐受性相当。恶心的发生率结论：雷米芬太尼在胃肠道内镜检查期间用于镇静的自我给药与丙泊酚的自我给药一样有效，可以提供给患者，尤其是当需要在手术过程中保持意识清醒时。

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