| 符永丰,黄应思,王世明,满元元,袁维秀.右美托咪定联合丙泊酚用于老年患者无痛肠镜的临床观察[J].,2017,17(28):5532-5535 |
| 右美托咪定联合丙泊酚用于老年患者无痛肠镜的临床观察 |
| Clinical Observation of Dexmedetomidine Combined with Propofol for Elderly Patients with Painless Colonoscopy |
| 投稿时间：2017-04-10 修订日期：2017-04-30 |
| DOI：10.13241/j.cnki.pmb.2017.28.031 |
| 中文关键词: 右美托咪定 丙泊酚 结肠镜检查 麻醉 |
| 英文关键词: Dexmedetomidine Propofol Colonoscopy Anesthesia |
| 基金项目:海南省社会发展基金资助项目（SF201429） |
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| 中文摘要: |
| 摘要 目的：探讨右美托咪定联合丙泊酚用于老年患者无痛纤维结肠镜检查术的麻醉效果及安全性。方法：选择ASA 1-II级择期行无痛肠镜检查术的86例患者随机分为两组，即右美托咪定联合丙泊酚（实验组）和丙泊酚和芬太尼组（对照组），每组各43例。 实验组先于10 min内缓解静脉输入右美托咪定 0.5 μg/kg，对照组同样时间内静脉输入1 μg/kg芬太尼。两组均静脉给予丙泊酚1.5 mg/kg，必要时追加丙泊酚。观察两组患者注药前(T0)、注药镜检前(T1)、过脾曲时(T2)、过肝曲时(T3)、退镜时(T4)的心率（HR）、收缩压（SBP）、血氧饱和度（SpO2）的变化，镇痛效果（VAS评分）、丙泊酚用量、苏醒时间及麻醉后不良反应发生情况。结果：实验组丙泊酚用量和苏醒时间明显短于对照组（P＜0.05），但两组VAS评分无统计学差异。实验组在T1-T4时间的HR和SBP显著低于对照组（P＜0.05），实验组SpO2在T2-T3时间显著高于对照组（P＜0.05）。观察组低血压、呼吸抑制、不良体动均显著低于对照组（P＜0.05）。两组嗜睡、头晕、恶心呕吐发生率无统计学差异。结论：右美托咪定联合丙泊酚用于老年患者无痛肠镜检查麻醉效果确切，相对丙泊酚联合芬太尼，可以减少丙泊酚用量，不良反应少，值得临床推广。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the effects and safety of dexmedetomidine combined with propofol for elderly patients with painless colonoscopy. Methods: 86 patients with ASAⅠ-Ⅱwho were undergoing painless colonoscopy were randomly divided into two groups: Dexmedetomidine combined with propofol group (experimental group) and propofol combined with fentanyl group (control group), 43 cases in each group. The experimental group was given intravenous injection of dexmedetomidine 0.5 μg/kg in the 10 minutes, while patients in the control group received 1 ug/kg fentanyl at the same time. Then two groups were given intravenous propofol 1.5 mg/kg, if necessary, additional propofol was given. Heart rate (HR)，systolic blood pressure (SBP)，and hemoglobin oxygen saturation levels (SpO2) were recorded at the time before injection (T0), injection before microscopy (T1), splenic flexure (T2), hepatic flexure (T3) and back mirror (T4). Analgesic effect (VAS score), propofol dosage, recovery time and the incidence of adverse reactions after anesthesia were also recorded. Results: The amount of propofol and the recovery time of the experimental group were significantly shorter than those of the control group (P<0.05), but there was no significant difference in VAS scores between the two groups. The HR and SBP of the experimental group were significantly lower than those of the control group (P<0.05) at the time of T1-T4, and the SpO2 in the experimental group was significantly higher than that in the control group (P<0.05) in T2-T3. The hypotension, respiratory depression, and the bad body movement in the observation group were significantly lower than those in the control group (P<0.05). There was no significant difference in the incidence of somnolence, dizziness, nausea and vomiting between the two groups. Conclusion: The effect of dexmedetomidine combined with propofol for painless colonoscopy in elderly patients was relatively good. Compared with propofol combined with fentanyl, experimental group could reduce the dosage of propofol and had less adverse reactions, and was worthy of clinical promotion. |
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