右美托咪定联合舒芬太尼在胃癌患者无痛超声胃镜检查中的应用及对患者循环系统的影响

Application of dexmedetomidine combined with sufentanil in painless ultrasound gastroscopy and its influence on patients′circulatory system

目的探讨右美托咪定联合舒芬太尼在无痛超声胃镜检查中的应用及对患者循环系统的影响。方法选择2016年10月—2017年12月在北京市大兴区人民医院接受无痛超声胃镜检查的108例胃癌患者作为观察对象,按照随机数表法分成对照组和研究组,各54例。对照组患者在普通超声胃镜检查中应用右美托咪定镇痛,研究组患者接受右美托咪定联合舒芬太尼进行麻醉镇痛。对比2组患者镇痛镇静效果、疼痛程度。检查前后循环系统变化及不良反应发生率。结果研究组Ramsay镇静评分高于对照组,VAS评分低于对照组,差异有统计学意义(P<0.05);2组患者检查前、检查后的脉搏氧饱和度(SpO 2)、心率(HR)、收缩压(SBP)、舒张压(DBP)差异无统计学意义(P>0.05);超声胃镜检查中,研究组患者的SpO 2高于对照组,HR、SBP、DBP低于对照组,差异有统计学意义(P<0.05);研究组患者恶心呕吐发生率及不良反应总发生率低于对照组,差异有统计学意义(P<0.05)。结论右美托咪定联合舒芬太尼在无痛超声胃镜检查中安全性高,效果显著,能增强镇痛镇静作用,维持循环系统稳定,值得临床推广。

Objective To study the application of dexmedetomidine combined with sufentanil in painless ultrasound gastroscopy and its influence on patients′circulatory system.Methods A total of 108 patients who underwent painless ultrasound gastroscopy in Beijing Daxing District People′s Hospital from October 2016 to December 2017 were selected as the subjects of this study.All the patients were divided into a control group and a study group using random number table method,with 54 cases in each group.Patients in the control group received dexmedetomidine analgesia in common ultrasound gastroscopy,while patients in the study group received dexmedetomidine combined with sufentanil for anesthesia and analgesia during ultrasound gastroscopy.The analgesic sedative effect,the degree of pain,the changes of circulatory system and the incidence of adverse reactions before and after the examination were compared between the two groups.Results The Ramsay sedation score of the study group was higher than that of the control group,and the Visual Analogue Scale(VAS)score was lower than that of the control group(P<0.05).There were no significant differences in pulse oxygen saturation(SpO 2),heart rate(HR),systolic blood pressure(SBP)and diastolic blood pressure(DBP)between the two groups before and after the examination(P>0.05).During the ultrasound gastroscopy,the SpO 2 of the study group was higher than that of the control group,while the HR,SBP and DBP were lower than those of the control group(P<0.05).The incidence of nausea and vomiting and total incidence of adverse reactions in the study group were lower than those in the control group,with statistical significance(P<0.05).Conclusions Dexmedetomidine combined with sufentanil is highly safe and effective in painless ultrasonic gastroscopy.It can enhance the analgesic and sedative effect and maintain the stability of the circulatory system,which is worthy of clinical promotion.