小剂量右美托咪定复合丙泊酚在无痛小肠镜检查中的临床效果及安全性

Safety and efficacy of low dose dexmedetomidine(Dex) combined with propofol for patients undergoing painless small intestinal endoscopy

目的探讨小剂量右美托咪定（DEX）复合丙泊酚在无痛小肠镜检查中对患者生命体征的影响。方法将无痛小肠镜患者70例随机分成实验组（D）组和对照组（C）组，每组35例，入室开放上肢静脉，吸氧，监测血压、心率、血氧饱和度。D组缓慢静脉推注（超过5min）右美托咪定0．3μg／kg，然后注射丙泊酚1mg／kg；C组单独静脉注射丙泊酚2mg／kg。检查中如有体动反应，追加丙泊酚0．2—0．5mg／kg，并观察丙泊酚用量、可唤醒时间及体动、循环、呼吸抑制等不良反应。结果丙泊酚总用药量D组明显低于C组（P〈0．05）；呼吸抑制例数和体动发生例数D组明显低于C组（P〈0．05）；循环抑制例数两组差异无统计学意义（P〉0．05）。结论在无痛胃镜检查中小剂量右美托咪定复合丙泊酚与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、镇痛效果，且大大降低丙泊酚用量。

Objective A clinical study was conducted to investigate the safety and efficacy of dexmedetomidine （Dex） combined with propofol for patients undergoing painless small intestinal endoscopy. Methods Seventy patients with ASA 1-2 requiring painless small intestinal endoscopy were randomized to 2 groups. Group D received Dex 0.3 I.Lg/kg （group D,n=35） followed by propofol 1 mg/kg, while group C received propofol 2.0 mg/kg （group C,n=35）.According to the body activity and operation time to determine whether to add propofol 0.2-0.5 mg/kg or not.Full recovery time, operation time, the consumed dose of propofol, mean arterial pressure （MAP）, heart rate （HR） and hemoglobin oxygen saturation levels（SPO2） were recorded. Results The consumed dose of propofol in group D were decreased to lower than that in group C（P〈0.05.）. The rate of hypotension and the body activity in group D was lower than that in group C（P〈 0.05）.The HR and MAP were similar in both groups. Conchmion It is effective and safe for low dose of Dex combined with propofol for sedation of patients undergoing painless small intestinal endoscopy.