摘要
目的观察不同剂量的右美托咪定联合舒芬太尼用于纤维肠镜检查术的效果。方法80例ASAⅠ～Ⅱ级行肠镜检查的患者，按右美托咪定负荷剂量不同，随机分为D1组（0．25μg／kg），D2组（0．5μg／kg），D3组（0．75μg／kg）和C组（0μg／kg），每组20例。静脉泵注右美托咪定负荷剂量，给药时间为10min，接着缓慢静脉给予舒芬太尼O．2μg瓜g，检查中DEX以0．5μg／（kg·h）速率持续输注至检查完毕。观察两组患者注药前（1、0）、进入乙状结肠曲（T1）、过脾曲时（112）、过肝曲时（T3），过回盲部（T4）及苏醒时（T5）HR、RR、MAP、SpO：的变化，记录麻醉镇痛效果、Ramsay镇静评分及不良反应发生率。结果与C组及T0时比较，D1、D2和D3组HR在T1～T5时均下降，Ramsay评分增加，与c组比较，D1-D3镇痛效果明显好于c组（P〈0．01）。结论给予右美托咪定负荷剂量O．75μg／kg后，以0．5μ／（kg·h）速率维持，可以安全用于无痛纤维结肠镜检查且麻醉效果满意。
Objective To evaluate the efficacy of different doses of dexmedetomidine combined with sulfentanil used for analgesic enteroscopy. Methods According to loading dose of dexmedetomidine, 80 patients of ASA Ⅰ - Ⅱ undergoing analgesic enteroscopy were randomly divided into 4 groups, group C （0μg/kg）, group DI（ 0.25 μg/kg）, group D2（0.5 μg/kg） and group D3（0.75 μg/kg） with 20 patients in each. They were administered with 0 （control） ,0.25,0.5 and 0.75 g/kg of dexmedetomidine.Intravenous infu- sion of dexmedetomidine loading dose was started within 10 min, followed by slow intravenous infusion of sufentanil 0.2 Ixg/kg, fol- lowed by a continuous infusion of dexmedetomidine 0.5 Ixg/（kg.h） to the end of the operation.The scale of anesthetic effect, HR, MAP, SpO2,Ramsay score and adverse effects were recorded before anesthesia （TO）, passing the sigmoid （T1）, passing the splenic flexure（T2）, passing the hepatic flexure（T3）,passing the ileocecal （T4） and awake（T5）. Results Compared with the values before administration and in control group,HR of patients in 0.25 Ixg.kgl（D1） , 0.5 μg·kgl（D2）, 0.75μg·kg（D3） decreased after dosing and the end of operation. Ramsay score increased after dosing and the end of operation. The analgesic effect in D1-D3 group was better than that in the C group（P〈0.01）. Conclusion The loading dose （0.75 μg/kg） of dexmedetomidine combined sulfentanil,fol- lowed by a continuous infusion of 0.5 μg/（kg.h） ,the anesthetic effect for patients undergoing enteroscopy is satisfactory and safe.
出处
《中外医疗》
2013年第30期47-49,共3页
China & Foreign Medical Treatment
