舒适化麻醉在无痛胃肠镜检查中的应用与实践

Application and Practice of Comfort Anesthesia in Painless Gastroenteroscopy

目的:探讨舒适化麻醉在无痛胃肠镜检查中的应用效果。方法:选取2022年4月—2023年4月邹平市精神卫生中心收治的100例无痛胃镜检查患者作为研究对象,根据随机数表法分为对照组(50例,常规麻醉)和观察组(50例,舒适化麻醉)。比较两组麻醉效果、生命体征、麻醉指标、应激反应及不良反应发生情况。结果:观察组麻醉优良率高于对照组,不良反应率低于对照组,差异有统计学意义(P<0.05)。两组T_(0)、T_(2)、T_(3)时心率(HR)、平均动脉压(MAP)比较,差异无统计学意义(P>0.05);观察组T1时HR、MAP高于对照组,差异有统计学意义(P<0.05)。观察组麻醉诱导时间、苏醒时间、体动反应次数、定向力恢复时间优于对照组,差异有统计学意义(P<0.05);两组检查时间比较,差异无统计学意义(P>0.05)。两组T0时应激反应指标比较,差异无统计学意义(P>0.05);观察组T3时皮质醇、去甲肾上腺素、肾上腺素水平低于对照组,差异有统计学意义(P<0.05)。观察组不良反应率低于对照组,差异有统计学意义(P<0.05)。结论:无痛胃肠镜检查中使用右美托咪定复合丙泊酚舒适化麻醉可提升麻醉效果和安全性,保持生命体征稳定,减轻应激反应。

Objective:To explore the application effect of comfort anesthesia in painless gastroenteroscopy.Method:A total of 100 patients with painless gastroscopy who admitted to Zouping Mental Health Center from April 2022 to April 2023 were selected as the research objects,they were divided into the control group(50 cases,routine anesthesia)and the observation group(50 cases,comfortable anesthesia)according to the random number table method.The anesthesia effect,vital signs,anesthesia indexes,stress response and adverse reactions were compared between two groups.Result:The excellent and good rate of anesthesia in the observation group was higher than that in the control group,and the adverse reaction rate was lower than that in the control group,the differences were statistically significant(P<0.05).There were no significant differences in heart rate(HR)and mean arterial pressure(MAP)between two groups at T_(0),T_(2)and T_(3)(P>0.05);the HR and MAP in the observation group at T_(1)were higher than those in the control group,and the differences were statistically significant(P<0.05).The anesthesia induction time,recovery time,body movement reaction times and directional force recovery time of the observation group were better than those of the control group,and the differences were statistically significant(P<0.05);there was no significant difference in the examination time between two groups(P>0.05).There were no significant differences in stress response indexes between two groups at T0(P>0.05);the levels of cortisol,norepinephrine and epinephrine in the observation group at T3 were lower than those in the control group,and the differences were statistically significant(P<0.05).The adverse reaction rate of the observation group was lower than that of the control group,and the difference was statistically significant(P<0.05).Conclusion:The use of Dexmedetomidine combined with Propofol for comfortable anesthesia during painless gastroenteroscopy can improve the anesthesia efficacy and safety,maintain the stability of vital signs and reduce stress reaction.