右旋美托咪啶联合异丙酚和瑞芬太尼在EST中的应用

Application of Intravenous Dexmedetomidine and Anesthesia with Remifentanil in Patient Undergoing Endoscopic Sphincterotomy

目的探讨右旋美托咪啶联合异丙酚和瑞芬太尼应用在EST取石手术的麻醉效果及安全性。方法行EST取石的患者随机分入A、B二组,A组给予异丙酚联合瑞芬太尼麻醉、B组给予右旋美托咪啶联合异丙酚和瑞芬太尼麻醉。观察这二组患者在麻醉中各时间段(诱导前后、术中、术毕)的平均动脉压(MAP)、心率(HR)、麻醉深度(BIS)、用药量、不良反应(躁动、呛咳)、清醒时间及手术时间。结果在基本相同的BIS下,二组患者的心率、平均动脉压在诱导前后有显著差异(P<0.01);术中平均动脉压B组高于A组;术中用药量A组多于B组。不良反应发生率、平均手术时间和平均清醒时间A组、B组差异不明显。结论右旋美托咪啶联合异丙酚和瑞芬太尼在减少异丙酚和瑞芬太尼输注量的同时能有效维持EST术中的血流动力学稳定,是EST手术安全有效的麻醉选择方式。

Objeetive Discuss the efficacy and safety of the dextral dexmedetomidine combined with propofol and remifentanil for anesthesia of EST. Methods The patients underwent EST randomly divided into A, B two groups, A group received propofol remifentanil, B group received dexmedetomidine joint propofol and remifentanil anesthesia. Observed that two groups of patients in anesthesia each time period （before and after induction, surgery, surgery） mean arterial pressure （MAP）, heart rate （HR）, the depth of anesthesia （B1S）, dosage, adverse reactions （irritability, cough ）, recovery time and operation time. Results Under the same BIS, two groups of patients with HR, MAP were significantly different before and after induction （P〈0.01）; intraoperative MAP in group B higher than in group A; intraoperative dosage group A more than B groups. Incidence of adverse reactions, the average operation time and average awake time in group A, B group was not significantly different. Conelusiou D dexmedetomidine combined propofol and remifentanil in reducing the amount of propofol and remifentanil infusion can effectively while maintaining EST intraoperative hemodynamic stability is a safe and effective surgical EST anesthetic alternatives.