盐酸右美托咪定复合丙泊酚用于无痛胃镜检查的临床观察

Clinical observation of dexmedetomidine hydrochloride combined with propofol for painless gastroscopy

目的 观察盐酸右美托咪定复合丙泊酚用于无痛胃镜检查对患者生命体征、麻醉效果及不良反应情况。方法 选择2017年4月至2018年4月在重庆市黔江中心医院行无痛胃镜检查97例患者作为研究对象,按随机数字表法将其分为观察组(50例)与对照组(47例)。观察组患者给予盐酸右美托咪定复合丙泊酚静脉输注,对照组患者给予枸橼酸芬太尼复合丙泊酚静脉输注,观察两组患者生命体征(HR、MAP、SpO2)指标、麻醉指标及不良反应情况。结果 胃镜检查前,两组HR、MAP、SpO2水平比较差异无统计学意义(P>0.05);胃镜检查时,观察组HR、MAP、SpO2水平较检查前无显著性差异(P>0.05),对照组HR水平较检查前显著上升,MAP、SpO2水平较检查前显著降低(P<0.01)。观察组丙泊酚用量明显少于对照组(P<0.01)。观察组麻醉起效时间、苏醒时间均明显早于对照组(P<0.01)。观察组发生恶心、呕吐、呼吸抑制、舌后坠等不良反应发生率为8.00%,显著低于对照组的25.53%(P<0.05)。结论 对行无痛胃镜检查患者给予右美托咪定复合丙泊酚静脉输注,可稳定患者生命体征,丙泊酚用量小,麻醉起效快,清醒时间早,有效减少心动或体动过速等应激反应,且药物安全性高,不良反应少,值得推广应用。

Objective Observation of dexmedetomidine hydrochloride combined with propofol for vital signs,anesthesia and adverse reactions in patients with painless gastroscopy. Methods From April 2017 to April 2018, 97 patients who underwent painless gastroscopy in our hospital were selected as subjects. They were randomly divided into observation group ( n =50) and control group ( n =47). Patients in the observation group were given dexmedetomidine hydrochloride combined with propofol intravenous infusion. Patients in the control group were given intravenous infusion of fentanyl citrate combined with propofol. The vital signs (HR, MAP, SpO 2) of the two groups were observed. AndAdverse reactions. Results Before gastroscopy, there were no significant differences in HR, MAP, and SpO 2 levels between the two groups ( P >0.05). There were no significant differences in HR, MAP, and SpO2 levels between the two groups ( P >0.05). The HR level of the control group increased significantly compared with that before the examination. The levels of MAP and SpO 2 were significantly lower than those before the examination ( P <0.01). The amount of propofol in the observation group was significantly lower than that of the control group ( P <0.01). The anesthesia effect time and recovery of the observation group The time was significantly earlier than the control group ( P <0.01).The incidence of adverse reactions such as nausea ,vomiting,respiratory depression ,and tongue fall in the observation group (8.00%) was significantly lower than that of the control group (25.53%)( P <0.05). Conclusion Intravenous infusion of dexmedetomidine combined with propofol in patients with painless gastroscopy can stabilize the patient’s vital signs, the dosage of propofol is small, the anesthesia is effective, the waking time is early, and the heartbeat or body movement is effectively reduced. Such as stress response,And the drug is safe and has few adverse reactions,which is worthy of promotion and application.