Nursing Care of Intravenous Anesthesia with Remifentanil for Painless Gastroscope

Objective To evaluate the efficacy,safety and points of Nursing care of intravenous anesthesia with remifentanil and propofol for painless gastroscope. Methods 180 patients scheduled for painless gastroscope were randomly allocated into remifentanil group and fentanyl group. Those in group remifentanil received remifentanil at the dose of 0.05μg(/kg·min)with micropump,while those in fentanyl group were given a bolus injection of fentanyl at 1.0μg/kg intravenously. One minute later,all the patients were given a loading dose of propofol of 0.4mg/kg followed by boluses of propofo(l0.2mg/kg)administered intermittently until Ramsay sedation scale III～IV. The induction time of anesthesia,intubation time of gastroscope,time of recovery from anesthesia and stay in the post anesthesia care uni(tPACU)were recorded. The mean arterial pressure(MAP),heart rate(HR),pulse oxygen saturation(SPO2)and respiratory rate(RR)were measured and recorded with noninvasive monitoring. The body movement,apnea,hypotension and bradycardiac were recorded during operation. All the patients were reviewed for satisfaction after the operation. Results The time of anesthesia induction,intubation time of gastroscope,time of recovery from anesthesia and stay in PACU in remifentanil group were shorter than those in fentanyl group(P0.05),and propofol consumption was significantly less in the former group (P0.05). Greater MAP decrement was observed in remifentanil group(P0.05). Much higher incidence of bradycardia or hypotension in remifentail groups was found than that in fentanil group(P0.05). Fewer patients had body movement while more had respiratory depression in remifentanil group than in fentanyl group(P0.05). No significant difference(P0.05)was observed between remifentanil group and fentanyl group in terms of the incidence of hypoxemia1. The rate of patientrated satisfaction was significantly higher in remifentanil group(P0.05). Conclusion Intravenous anesthesia with remifentanil and propofol for gastroscope is safe and reliable,Intravenous remifentanil and propofol for gastroscopy provides more bradycardia or hypotensio compared with intravenous fentanyl and propofol. Cautions should be taken by the frequent occurrence of hypoxemia with intravenous remifentani. The guardianship and the nursing care are important to painless gastroscope.