盐酸右美托咪定辅助七氟醚在食管镜检查中的应用60例

Use of dexmedetomidine in patients undergoing esophagoscopy

目的:研究盐酸右美托咪定(dexmedetomidine,Dex)辅助七氟醚在食管镜检查中的效果.方法:将60例择期行食管镜检查的患者随机分为对照组和右美托咪定组,两组均保持自助呼吸,吸入七氟醚浓度2%,右美组吸入七氟醚前10min先静脉输入右美0.5g/kg;对照组泵注等量生理盐水作对照,二组密切观察血压、心率、脑电双频指数(bispectral index,BIS).结果:组间比较:B组患者平均动脉压(mean artery pressure,MAP)在T2为106mmHg±6mmHg、T3为101mmHg±3mmHg、T4为101mmHg±4mmHg、T5为101mmHg±5mmHg、T6为96mmHg±2mmHg,A组患者MAP在T2为122mmHg±7mmHg、T3为120mmHg±4mmHg、T4为120mmHg±5mmHg、T5为122mmHg±7mmHg、T6为128mmHg±6mmHg,B较A组明显降低(P<0.05).B组患者心率(heart rate,HR)R在T2为71bpm±7bpm、T3为71bpm±9bpm、T4为71bpm±10bpm,A组患者HR在T2为78bpm±10bpm、T3为78bpm±7bpm、T4为78bpm±8bpm,T2、T3、T4时B组HR较A组明显降低(P<0.01),T6时B组HR为67bpm±6bpm、A组HR为71bpm±8bpm,B组明显降低(P<0.05).B组BIS值T2、T4、T6为57.15±6.19、55.80±8.75、80.25±4.37,A组相应值为60.15±4.14、93.45±6.57、60.45±7.90,B较A组明显降低(P<0.05),B组患者BIS值≤50的时间比A组长(P<0.05),诱导过程中B组4例心动过缓发生率高于A组(P<0.05);A组苏醒期有3例躁动发生率高于B组(P<0.05).右美托定组血流动力学稳定,患者配合度好.结论:Dex用于食管镜检查,患者更容易配合操作,且生命体征平稳,一般情况良好.

AIM： To explore the use of dexmedetomidine in patients undergoing esophagoscopy. METHODS： Patients who underwent esophagoscopy were randomly divided into a control group and a DEX group. Anesthesia was maintained in all subjects with 2% sevoflurane under spontaneous breathing. The DEX group was intravenously injected with dexmedetomidine 0.5 g/kg 10 min before anesthesia, while the control group was injected with equal volume of saline. Blood pressure, heart rate, and bispectral index （BIS） were monitored in both groups. RESULTS： The mean arterial pressure at T2-T6 were significantly lower in the DEX group than in the control group （106 mmHg±6 mmHg vs 122 mmHg±7 mmHg, 101 mmHg±3 mmHg vs 120 mmHg±4 mmHg, 101 mmHg±4 mmHg vs 120 mmHg±5 mmHg, 101 mmHg±5 mmHg vs 122 mmHg±7 mmHg, 96 mmHg±2 mmHg vs 128 mmHg±6 mmHg all P 0.05）. The heart rate at T2-T4 were significantly decreased in the DEX group compared to the control group（71 bpm±10 bpm vs 78 bpm±10 bpm, 71 bpm±9 bpm vs 78 bpm±7 bpm, 71 bpm±7 bpm vs 78 bpm±8 bpm, all P 0.01）. The heart rate at T6 was also significantly lower in the DEX group than in the control group （67 bpm±6 bpm vs 71 bpm±8 bpm, P 0.05）. The BIS at T2-T6 was significantly lower in the DEX group than in the control group （57.15±6.19 vs 60.15±4.14, 55.80±8.75 vs 93.45±6.57, 80.25±4.37 vs 60.45±7.9, all P 0.05）. The time when BIS was lower than or equal to 50 was longer in the DEX group than in the control group. The incidence of bradycardia was higher in the DEX group than in the control group （P 0.05）. Dysphoria occurred in three patients of the control group A, but did not occur in the DEX group. The incidence of dysphoria was lower in the DEX group, and patient compliance was better in the DEX group （P 0.05）. CONCLUSION： Use of dexmedetomidine in patients undergoing esophagoscopy can help keep stable vital signs and obtain good patient compliance