右美托咪定与丙泊酚联用于老年患者无痛胃镜麻醉的临床观察

Clinical Observation of Dexmedetomidine Combined with Propofol for Anesthesia in Elderly Patients with Painless Gastroscopy

目的:观察右美托咪定与丙泊酚联用在老年患者无痛胃镜麻醉中的效果及安全性。方法:拟行无痛胃镜检查的老年患者70例随机分为观察组(35例)和对照组(35例);观察组给予右美托咪定联合丙泊酚麻醉,对照组给予丙泊酚麻醉。比较两组患者的麻醉诱导时间、苏醒时间,患者不同时点的生命体征,术中并发症、药品不良反应等指标。结果:观察组麻醉诱导时间、苏醒时间均短于对照组(P<0.01)。两组患者平均动脉压(MAP)在T2、T3、T4阶段均明显低于T1阶段(P<0.05或P<0.01);对照组的HR在T3阶段、R在T2阶段均低于T1阶段(P<0.05);观察组的RR在T2阶段明显低于T1阶段(P<0.05);观察组MAP在T2、T3阶段明显高于对照组(P<0.01),在T4阶段低于对照组(P<0.05);观察组的HR在T3阶段明显高于对照组(P<0.05)。观察组患者术中并发症显著低于对照组(P<0.05)。结论:右美托咪定联合丙泊酚的麻醉效果与安全性均高于单用丙泊酚,值得临床推广应用。

Objective： To observe the clinical effect of the combined use of dexmedetomidine and propofol for anesthesia in the elderly patients with painless gastroscopy. Methods： Totally 70 elderly patients with painless gastroscopy were selected and randomly divided into the observation group （35 cases） and the control group （35 cases）. The observation group was given dexmedetomidine and propofol for anesthesia, while the control group was given propofol for anesthesia. The anesthesia induction time, the vital signs and recovery time of the patients, intraoperative complications and postoperative adverse reactions were observed and compared between the two groups. Results ： The anesthesia induction time of the observation group was shorter than that of the control group （ P 〈 0.01 ）. The mean arterial pressure （MAP） in T2, T3 and T4 stage in the two groups were significantly lower than that in T1 stage （P 〈 0.05, P 〈 0.01 ）. The HR in T3 stage and RR in T2 stage in the control group were lower than those in T1 stage （P 〈 0.05 ）. The RR in T2 stage in the observation group was significantly lower than that in T1 stage （ P 〈 0.05 ）. The MAP in T2 and T3 stage in the observation group was significantly higher than that in the control group （ P 〈 0.01 ）, while that in T4 stage in the observation group was significant- ly lower than that in the control group （P 〈 0.05 ）. The HR in T3 stage in the observation group was significantly higher than that in the control group （ P 〈 0.05 ）. The incidence of intraoperative complications in the observation group was 5.7%, while that in the control group was 22.9%, and there was significant difference between the two groups （P 〈 0.05）. The recovery time in the observation group was shorter than that in the control group （P 〈 0.01 ）. Conclusion： Dexmedetomidine combined with propofol has better anesthesia effect and higher safety than propofol alone, which is worthy of clinical promotion.