右美托咪定联合丙泊酚在无痛纤维结肠镜检查中的应用

Application of Dexmedetomidine Combined with Propofol in Painless Fibercolonoscope

目的:分析右美托咪定联合丙泊酚在无痛纤维结肠镜检查中的应用效果。方法:选择2019年1月-2020年10月在本院进行无痛纤维结肠镜检查的80例患者为试验对象,以随机数字表法将其分为观察组(40例)与对照组(40例),对照组采取丙泊酚麻醉,观察组应用右美托咪定联合丙泊酚麻醉,对比两组麻醉效果、麻醉指标,以及检查前(T0)、丙泊酚给药5 min(T_(1))、过脾曲(T_(2))、过肝曲(T_(3))、检查结束(T4)血流动力学指标[平均动脉压(MAP)、心率(HR)],体动反应程度、不良反应发生率。结果:观察组麻醉优良率(95.0%)高于对照组(80.0%);麻醉起效时间、清醒时间早于对照组,丙泊酚用量少于对照组;T_(1)、T_(2)、T_(3)时MAP高于对照组,T_(1)、T_(2)、T_(3)、T4时HR低于对照组;体动反应程度较对照组更轻微;不良反应发生率(10.0%)低于对照组(32.5%),差异均有统计学意义(P<0.05)。结论:在无痛纤维结肠镜检查中应用右美托咪定联合丙泊酚麻醉可取得很好的麻醉效果,且能减少丙泊酚用量,麻醉安全性也比较高,不会增加呼吸、循环抑制作用,不良反应也较少,此麻醉方案值得借鉴推广。

Objective:To analyze the effect of Dexmetomidine combined with Propofol in painless fibercolonoscope.Method:A total of 80 patients underwent painless fibercolonoscope in our hospital from January 2019 to October 2020 were selected as study objects,and divided into observation group(40 cases)and control group(40 cases)by random number table method.The control group was anesthetized with Propofol,the observation group was anesthetized with Dexmedetomidine combined with Propofol.The effects of anesthesia,indexes of anesthesia,hemodynamic indexes[mean arterial pressure(MAP),heart rate(HR)]before examination(T0),5 min of Propofol administration(T_(1)),after splenic flexure(T_(2)),after hepatic flexure(T_(3)),end of examination(T4),the degree of body motion reaction and the incidence of adverse reactions were compared between the two groups.Result:The excellent and good rate of anesthesia in the observation group(95.0%)was higher than 80.0%in the control group;the onset time of anesthesia and waking time were earlier than those of control group,the dosage of Propofol was less than that of control group;MAP at T_(1),T_(2),T_(3)were higher than those of the control group,HR at T_(1),T_(2),T_(3),T_(4) were lower than those of control group;the degree of body motion response was more slight than that of control group;the incidence of adverse reactions(10.0%)was lower than 32.5%of the control group,the differences were statistically significant(P<0.05).Conclusion:Dexmedetomidine combined with Propofol anesthesia can achieve good anesthetic effect in painless fibercolonoscope,and can reduce the amount of Propofol,the safety of anesthesia is also high,without increasing the inhibition of respiratory circulation and fewer adverse reactions.This anesthesia program is worth learning and promoting.