右美托咪定在无痛胃镜患者围术期镇静效应及血流动力学影响

The Sedative Effect and Haemodynamic Influence of Dexmedetomidine on Patients Undergoing Painless Gastroscopy Examination

目的:探讨右美托咪定在无痛胃镜患者围术期应用的镇静效应及对血流动力学的影响。方法:选择无痛胃镜患者40例(ASAⅠ～Ⅱ)随机分成Dex组(D组)和对照组(C组)各20例。C组单独静脉注射丙泊酚2.5mg/kg,D组在注射丙泊酚前缓慢静脉推注(超过10min)右美托咪啶0.8μg/kg。记录用药前(T0)、手术开始时(T1)、胃镜进入胃内时(T2)、手术完成时(T3)的MAP、HR、SpO2、OAA/S及Ramsay镇静评分,并观察丙泊酚的总用量、诱导时间和唤醒时间。结果:T1～T3D组Ramsay评分明显高于C组和T0(P<0.05),OAA/S评分降低(P<0.05)。T1～T3患者HR和MAP降低(P<0.05),D组的诱导时间、唤醒时间明显比C组缩短,丙泊酚总用量比C组减少(P<0.05),所有患者无明显呼吸抑制。结论:Dex 0.8μg/kg用于无痛胃镜患者围术期可以产生明显的镇静效应,有一定降压作用且无呼吸抑制。

Objective： To study the sedative effect and haemodynamic influence of dexmedetomidine on patients under- going painless gastroscopy examination. Methods; 40 patients in need of painless gastroscopy were randomized into two groups, the Dex group （D group） and the control group （C group）. Each group contains 20 patients. In the C goup, a single dose of 2. 5mg/kg propofol was infused. While in the D group, 0. 8μg/kg of Dexmedetomidine was infused slowly （longer than 10 minutes） before propofol application. A series of index, including MAP, HR, SpO2, OAA/S, and ramsay sedation score were recorded at four different time points, before infusion（T0 ）, at beginning of operation（T1 ）, when gastrocopy entered the stomach（T2 ）, after the operation was finished（T3 ）. The total dosage of propofol, induction time and arousing time were also observed. Results：The Ramsay sedation scores at T1, T2 and T3 of D group are statistically higher than the C group and the To group（P〈0. 05）, while the HR and MAP of the three time points are relatively lower（P〈0. 05）. The D group showed shorter induction times and arousing times as well as less propofol dosage than the C group（P〈0. 05）. No patients showed signs of breath suppression. Conclusion： 0. 8μg/kg of dexmedetomidine used at pert-operative period of painless gastroscopy examination can yield marked sedative effect,has antihypertensive effect to some degree,and do not suppress breath.