Narcotrend麻醉深度监测下右美托咪定复合丙泊酚在结肠息肉切除术中的应用

摘要

Objective This clinical study was conducted to investigate the effects of dexmedetomidine (DEX) combined with propofol on vital signs and anaesthetic depth in patients. Methods Ninty patients with ASA 1-2 requiring painless colono-scopy for colonic polyps resection were randomized to receive DEX 0.3μg/kg (group D, n=45) followed by propofol 1 mg/kg or propofol 2 mg/kg (group C, n=45), and according to the body activity and operation time, additional doses of propofol (0.2-0.5 mg/kg) were given. The full recovery time,operation time, consumed dose of propofol, mean arterial pressure(MAP), heart rate (HR), hemoglobin oxygen saturation levels(SPO2) and NTI were recorded.Results The SPO2、recover time and the consumed dose of propofol in group D were decreased compared to those in group C (P<0.01). The rate of the body activity in group D was lower than that in group C (P<0.05). The NTI in group C was lower than that in group D (P<0.05). The HR and MAP were similar in both groups. Conclusion Under Narcotrend monitoring, the value of DEX combined with low dose of propofol in colonoscopy for colonic polyps resection is to reach more reasonable depth of anesthesia to reduce adverse responses and the dose of propofol.%目的：探讨Narcotrend麻醉深度监测下右美托咪定复合丙泊酚在无痛结肠镜结肠息肉切除术中对患者生命体征及麻醉深度的影响。方法选择无痛结肠镜患者90例随机分成Dex组（D）组和对照组（C）组各45例，入室开放上肢静脉，吸氧，监测血压、心率、脉氧饱和度和麻醉深度指数（NTI）。D组缓慢静脉泵注（10 min）右美托咪定0.3μg/kg，然后注射丙泊酚1 mg/kg；C组单独静脉注射丙泊酚2 mg/kg。检查中如有体动反应，追加丙泊酚0.2~0.5 mg/kg。观察丙泊酚用量、可唤醒时间及体动、循环、呼吸抑制等不良反应。结果丙泊酚总用药量和呼吸抑制例数D组明显低于C组（P<0.05）；体动发生例数D组明显低于C组（P<0.05）；循环抑制例数两组无明显差异（P>0.05）；麻醉深度指数（NTI）C组明显低于D组（P<0.05）。结论 Narcotrend麻醉深度监测下右美托咪定复合丙泊酚同单独使用丙泊酚相比能达到更合理的麻醉深度以减少不良反应，并能提供更佳的镇痛效果且大大降低丙泊酚用量。