利多卡因胶浆表面麻醉复合小剂量丙泊酚在老年无痛胃镜检查中的应用

目的 探讨利多卡因胶浆表面麻醉复合小剂量丙泊酚静脉麻醉用于老年患者无痛胃镜检查及治疗的可行性.方法 156例自愿接受无痛胃镜检查的65岁以上老年患者采用数字表法随机分为：复合表面麻醉组（LP组,n=78）,胃镜检查前患者含服2%盐酸利多卡因胶浆10 mL,表面麻醉后缓慢静脉注射小剂量丙泊酚（0.8～1.5 mg/kg）,使患者进入麻醉状态,再进行胃镜检查;单纯丙泊酚麻醉组（P组,n=78）,静脉缓慢注射丙泊酚（1～1.8 mg/kg）,待患者进入麻醉状态后进行胃镜检查.记录胃镜检查前、检查中和检查后的血氧饱和度（oxyhemoglobin saturation,SpO2）、血压（blood pressure,BP）、心率（heart rate,HR）的变化,记录检查中呛咳反应和体动的发生率,以及检查后询问患者是否愿意接受再次检查（复检率）.结果 所有患者均顺利完成检查及治疗,未出现明显恶心呕吐、体动等症状,无呼吸抑制发生.2组患者检查前、检查中、检查后的血流动力学比较,差异无统计学意义（P〉0.05）;LP组患者检查中出现呛咳反应和咽部不适明显少于P组（P〈0.05）;LP组愿意接受再次胃镜检查的患者数,明显高于P组（P〈0.05）;LP组丙泊酚用量明显低于P组（P〈0.05）.结论 利多卡因胶浆表面麻醉复合小剂量丙泊酚静脉麻醉用于老年患者无痛胃镜检查,安全、舒适,是一种较为可行的麻醉方法.

Lidocaine mucilage topic anesthesia combined with propofol intravenous anesthesia in elderly patients for painless gastroscopy

Objective To evaluate efficacy and safety of lidocaine mucilage topical anesthesia combined with propofol intravenous anesthesia in elderly patients for painless gastroscopy. Methods A total of 156 patients were allocated randomly into two groups: lidocaine mucilage and propofol anesthesia group (Group LP, n=78), merely propofol anesthesia group (Group P, n=78). Patients cardiovascular responses, including pulse oxygen saturation (SpO₂), blood pressure (BP), and heart rate (HR), were recorded before, during, and 30 min after gastroscopy. Swallowing reflex during the examination was observed, total dose of the propofol and patients number who would not receive the examination again were documented.Results All patients had finished the examination, without serious nausea and vomiting or obvious body moving. No respiratory depression happened during anesthesia. Cardiovascular responses to the anesthesia and examination were stable and there were no significant differences between both groups(P>0.05). The incidence of cough and throat discomfort were lower in Group LP, when compared with Group P(P<0.05). The total dose of propofol used was less in Group LP than in Group P(P < 0.05). More patients in Group LP would like to receive gastroscopy examination, when compared with Group P(P < 0.05). Conclusion Lidocaine mucilage topical anesthesia combined with intravenous propofol anesthesia is a safe, comfortable and suitable method for elderly patients undergoing painless gastroscopy examination.