小剂量右美托咪定复合丙泊酚在内镜黏膜下剥离术中的应用

Low dose of dexmedetomidine combined with propofol in endoscopic submucosal dissection

目的观察小剂量右美托咪定复合丙泊酚在内镜黏膜下剥离术（ESD）中的麻醉效果及安全性。方法选择80例ASAⅠ～Ⅱ级行ESD的患者，随机分为2组，每组40例，P组为丙泊酚组，M组为小剂量右美托咪定（0．5μg／kg）复合丙泊酚组。记录各时间点血流动力学、呼吸、血氧饱和度，手术时间与苏醒时间，丙泊酚、芬太尼用量及不良反应。结果两组血流动力学、呼吸、血氧饱和度，手术时间差异无统计学意义；与P组相比，M组丙泊酚、芬太尼用量少、苏醒时间短、不良反应少（P〈0．05）。结论小剂量右美托咪定复合丙泊酚在ESD中的应用是安全有效的。

Objective To evaluate the effect and safety of low dose of dexmedetomidine combined with propofol used in endoscopic submucosal dissection （ESD）. Methods 80 ASA Ⅰ～Ⅱ level patients in need of ESD were selected and randomly divided into 2 groups ： Group P was given propofol; Group M was given low dose of dexmedetomidine combined with propofol. The following data were recorded ： blood-pressure, cardiac rate at each point during anesthesia,the time of operation and tracheal extubation and palinesthesia, propofol and Fentanyl dosage, and adverse reaction. Results There was no significant difference in the time of operation between the two groups ; compared with the P group, the dosage of propofol in M group is less, stable bemodynamies,the time of tracheal extubation and palinesthesia were shorter with less adverse reactions （ P 〈 0.05 ）. Conclusion The anesthetic effect of low dose of dexmedetomidine combined with propofol in ESD was satisfactory and safe.