右美托咪定复合小剂量丙泊酚在无痛胃镜检查中对患者生命体征及麻醉深度的影响

Effects of dexmedetomidine combined with low dose of propofol on vital signs and anaesthetic depth in patients undergoing painless gastroscopy

目的:探讨右美托咪定复合小剂量丙泊酚在无痛胃镜检查中对患者生命体征及麻醉深度的影响。方法:选择无痛胃镜患者90例随机分成Dex组(D)组和对照组(C)组各45例,入室开放上肢静脉,吸氧,监测血压、心率、血氧饱和度和麻醉深度指数(NTI)。D组缓慢静脉注射(超过5 min)右美托咪定0.5μg/kg,然后注射丙泊酚1.5 mg/kg;C组单独静脉注射丙泊酚2.5 mg/kg。检查中如有体动反应,追加丙泊酚0.3～0.5 mg/kg,并观察丙泊酚用量及体动、呼吸和循环抑制等不良反应。结果:丙泊酚总用药量D组明显低于C组(P<0.05);呼吸抑制例数和严重体动发生例数D组明显低于C组(P<0.05);NTI D组明显高于C组(P<0.01);循环抑制例数两组无明显差异(P>0.05)。结论:在无痛胃镜检查中右美托咪定复合小剂量丙泊酚同单独使用丙泊酚相比具有更好的安全性,能提供更佳的术中镇静效果且大大降低丙泊酚用量。

Objective To investigate the effects of dexmedetomidine （DEX） combined with low dose of propofor on vital signs and anaesthetic depth in patients undergoing painless gastroscopy. Methods Ninety patients with ASA I II requiring gastroscopy were randomly assigned to received 0.5 Ixg/kg of DEX （Group D, n = 45） followed by 1.5 mg/kg of propofol or 2.5 mg/kg of propofol （Group C, n = 45）. 0.3 - 0.5 mg/kg of propofol was added or not according to the body activity and operation time. Full recovery time, operation time, the consumed dose of propofol, mean arterial pressure （MAP）, heart rate （HR）, hemoglobin oxygen saturation levels （Sp02） and NTI were recorded. Results The consumed dose of propofol, the rate of body activity and respiratory depression in Group D were significantly lower than those in Group C （P 〈 0.05 ）. The NTI in Group C was lower than that in Group D （P 〈 0.05） ; and the HR and MAP were similar in both groups. Conclusions DEX combine with low dose of propofol for sedation of patients undergoing painless gastroscopy are more effective and safe than propofol alone.