右美托咪定联合异丙酚对老年患者无痛胃镜检查中血流动力学水平的影响

摘要

目的 观察右美托咪定联合异丙酚对老年患者无痛胃镜检查中血流动力学水平的影响.方法 选取金华市中心医院于2015年9月~2016年9月行胃镜检查术68例患者,随机分为观察组与对照组,每组各34例.观察组采用右美托咪定联合异丙酚复合麻醉,对照组单独使用异丙酚麻醉.观察2组患者给药前(T0)、给药完毕(T1)、插入胃镜时(T2)、检查完毕(T3)、检查完毕后5 min(T4)的RR(呼吸频率)、HR(心率)、MAP(平均动脉压)和SpO2(脉搏氧饱和度)情况;对比2组患者术后意识、定向力恢复时间及手术耐受度情况,并记录2组患者手术过程中出现的麻醉不良反应.结果 观察组在T1、T2、T3、T4时间点HR均低于对照组,且数据维持相对稳定水平,差异有统计学意义(P<0.05).观察组与对照组患者意识恢复时间、定向力恢复时间,差异不具有统计学意义;观察组耐受度高于对照组,差异有统计学意义(P<0.05).观察组总不良反应发生率为32.35%低于对照组总不良反应发生率88.24%,差异有统计学意义(P<0.05).结论 右美托咪定复合异丙酚用于老年患者无痛胃镜,镇痛效果佳,且能够更好的维持血流动力学波动,减少异丙酚单独麻醉的不良反应,不影响患者意识及定向能力的恢复.%Objective To observe the effects of dexmedetomidine combined with propofol on the hemodynamics level in elderly patients undergoing gastroscopy.Methods 68 patients undergoing endoscopy from January 2014 to January 2015 in our hospital were selected and randomly divided into observation group and control group, 34 cases in each group.Propofol anesthesia combined with dexmedetomidine was used in the observation group and propofol anesthesia was used in the control group.The RR ( respiratory rate) and HR ( heart rate) of the two groups were observed before the administration (T0), after the administration (T1), when the gastroscope was inserted (T2), after the examination (T3), 5 min after the examination (T4), MAP (mean arterial pressure) and SpO2(pulse oxygen saturation) were measured.The postoperative consciousness, orientation recovery time and surgical tolerance were compared between the two groups.The anesthetic adverse reactions were recorded during the operation.Results The observation group in T1, T2, T3, T4 time point HR were lower than the control group, and the data remained relatively stable level, the difference was statistically significant (P<0.05).There was no significant difference in consciousness recovery time and recovery time of orientation force between observation group and control group.The tolerance of the observation group was higher than that of the control group, the difference was statistically significant (P<0.05).The total adverse reaction rate of the observation group was 32.35% lower than that of the control group 88.24%, the difference was statistically significant ( P <0.05 ) .Conclusion Dexmedetomidine combined with propofol for the elderly patients with painless gastroscopy , analgesic effect is good, and can better maintain hemodynamic fluctuations, reduce propofol anesthesia adverse reactions, does not Affect the patient's awareness and ability to restore the direction.