右美托咪定复合丙泊酚用于无痛纤维结肠镜检查术的效果

摘要

Objective To evaluate the effect and safety of propofol with dexmedetomidine in patients with analgesic enteroscopy. Methods Fifty ASA ofⅠ or Ⅱ patients undergoing analgesic enteroscopy were randomly divided into two groups: group D (25 cases) was administrated intravenously dexmedetomidine 1 fig/kg followed by propofol 2mg/kg; group P (40 cases) was administrated propofol 2. 5 mg/kg. The scale of anethetic effect, HR,BP,SpO2 at before anesthesia (T0), 2 min after injection(T1),passing the splenic flexure(T2), passing the hepatic flexure(T3) and awake(T4) were monitored, the time of acting anesthetics, recovery, discharge were recorded, adverse reaction and complication after anesthesia were also recorded. Results The anethetic effect in group D was better than in group P (P<0. 05). In two groups, HR, SBP,and SpO2 at T1 were lower than at To(P<0. 05). The HR and SBP of patients in group D at T2-T4 were lower than those in group P and at T0 (P<0. 05). The time of recovery of patients in group P was longer than that in group D (P<0. 05). The incidence of agitation and headache in group P was higher than that in group D (P<0. 05). The amount of propofol of both was significantly differently between the two groups (P <0. 05). Conclusion The anesthetic effect of dexmedetomidine combined with propofol for patients undergoing enteroscopy is satisfactory and safety.%目的 观察右美托咪定复合丙泊酚用于无痛纤维结肠镜检查术的麻醉效果及安全性.方法 50例ASA Ⅰ或Ⅱ级行纤维结肠镜检查术患者,随机分为右美托咪定复合丙泊酚组(D组)和丙泊酚组(P组),每组25例.D组10 min内缓慢静脉注射右美托咪定1μg/kg,再静脉注射丙泊酚2mg/kg;P组单独静脉注射丙泊酚2.5 mg/kg,必要时追加丙泊酚.对两组患者的麻醉镇痛效果进行评级；观察两组患者注药前(T0)、注药后2 min(T1)、过脾曲时(T2)、过肝曲时(T3)及苏醒时(T4)HR、RR、SBP、SpO2的变化；以及麻醉起效时间、苏醒时间和离院时间；麻醉后不良反应发生情况.结果 D组镇痛效果优于P组(P＜0.05).T1时两组HR慢于、SBP及SpO2均明显低于T0时(P＜0.05).T2～T4时D组HR慢于、SBP低于P组和T0时(P＜0.05).P组起效、苏醒和离院时间长于D组(P＜0.05),P组丙泊酚用量明显高于D组(P＜0.05).术中舌后坠和呼吸抑制P组明显高于D组(P＜0.05),P组苏醒时头晕、躁动发生率明显高于D组(P＜0.05).结论 右美托咪定复合丙泊酚可以安全用于无痛纤维结肠镜检查且麻醉效果满意.