右美托咪定复合瑞芬太尼在无痛胃肠镜检查中的应用效果

Effect of Dexmedetomidine Combined with Remifentanil in Painless Gastrointestinal Endoscopy

目的:探究在无痛胃肠镜检查中应用右美托咪定复合瑞芬太尼麻醉的临床效果。方法:选取2022年3-12月于贵州盘江煤电集团有限责任公司医院行无痛胃肠镜检查的患者74例作为研究对象,随机分为研究组和对照组,各37例。研究组注射右美托咪定复合瑞芬太尼。对照组注射芬太尼和丙泊酚。比较两组术后Ramsay镇静评分、平均动脉压(MAP)、血氧饱和度(SpO_(2))、心率(HR)和呼气末二氧化碳分压(PETCO_(2))、不良反应率。结果:插管时(T_(1))两组Ramsay镇静评分比较,差异无统计学意义(P>0.05);插管后5min(T_(2))、手术结束时(T_(3))、拔管时(T_(4))研究组Ramsay镇静评分高于对照组,差异有统计学意义(P<0.05);研究组T_(2)、T_(3)、T_(4)MAP水平高于对照组,差异有统计学意义(P<0.05);研究组T_(2)和T_(3) HR低于对照组,差异有统计学意义(P<0.05);研究组T_(2)和T_(3)时PETCO_(2)高于对照组,差异有统计学意义(P<0.05);研究组不良反应发生率低于对照组,差异有统计学意义(P<0.001)。结论:右美托咪定复合瑞芬太尼在无痛胃肠镜检查中具有良好的应用价值,镇静效果显著,生命体征更稳定,安全性较高。

Objective:To explore the clinical effect of dexmedetomidine combined with remifentanil anesthesia in painless gastrointestinal endoscopy.Methods:74 patients who underwent painless gastrointestinal endoscopy at Guizhou Panjiang Coal and Electricity Group Co.,Ltd.Hospital from March to December 2022 were selected as research subjects and randomly divided into a research group and a control group,with 37 cases in each.The research group was injected with dexmedetomidine combined with remifentanil.The control group was injected with fentanyl and propofol.The postoperative Ramsay sedation score,mean arterial pressure(MAP),blood oxygen saturation(SpO_(2)),heart rate(HR),end-tidal carbon dioxide partial pressure(PETCO_(2)),and adverse reaction rate were compared between the two groups.Results:There was no statistically significant difference in the Ramsay sedation scores between the two groups at the time of intubation(T_(1))(P>0.05);the Ramsay sedation score of the study group was higher than that of the control group 5 minutes after intubation(T_(2)),at the end of the operation(T_(3)),and at the time of extubation(T_(4)),and the difference was statistically significant(P<0.05);the T_(2),T_(3),and T_(4) MAP levels of the study group were higher than those of the control group,and the difference was statistically significant(P<0.05);the T_(2) and T_(3) HR of the study group were lower than those of the control group,and the difference was statistically significant(P<0.05);the PETCO_(2) of the study group at T2 and T3was higher than that of the control group,and the difference was statistically significant(P<0.05);the incidence of adverse reactions in the study group was lower than that of the control group,and the difference was statistically significant(P<0.001).Conclusion:Dexmedetomidine combined with remifentanil has good application value in painless gastrointestinal endoscopy,with significant sedation effect,more stable vital signs and higher safety.