右美托咪定联合丙泊酚在无痛胃镜检查中的镇静效果及对患者满意度的影响

Sedative Effect of Dexmedetomidine Combined with Propofol in Painless Gastroscopy and its Effect on Patient Satisfaction

目的研究右美托咪定(Dex)联合丙泊酚(Pro)在无痛胃镜检查中的镇静效果,以及对患者满意度的影响。方法以2021年9月-2023年9月天津市滨海新区中医医院行无痛胃镜检查的120例受检者为研究对象,采用随机数字表法分为对照组和观察组,各60例。对照组选择舒芬太尼联合Pro静脉复合麻醉;观察组应用Dex联合Pro静脉复合麻醉,比较两组镇静效果(麻醉诱导时间、Ramsay镇静评分)、胃镜检查相关指标(胃镜检查时间、苏醒时间、丙泊酚用量)、血流动力学水平[心率(HR)、平均动脉压(MAP)]、麻醉不良反应及患者满意度。结果观察组麻醉诱导时间短于对照组,Ramsay镇静评分低于对照组(P<0.05)。观察组胃镜检查时间、苏醒时间短于对照组,且丙泊酚用量少于对照组(P<0.05)。进镜时,两组HR、MAP水平低于麻醉前,但观察组HR、MAP水平高于对照组(P<0.05);退镜后,两组HR、MAP水平比较,差异无统计学意义(P>0.05)。观察组麻醉不良反应发生率小于对照组,患者满意度高于对照组(P<0.05)。结论Dex联合Pro静脉复合麻醉在无痛胃镜检查中具有良好镇静效果,其麻醉诱导时间短、苏醒快、血流动力学波动小,可减少患者的胃镜检查时间与丙泊酚用量,降低麻醉不良反应风险,提高患者满意度。

Objective To study the sedative effect of dexmedetomidine(Dex)combined with propofol(Pro)in painless gastroscopy and its effect on patient satisfaction.Methods A total of 120 subjects who underwent painless gastroscopy in Tianjin Binhai New Area Hospital of Traditional Chinese Medicine from September 2021 to September 2023 were selected as the research objects.They were divided into control group and observation group by random number table method,with 60 subjects in each group.The control group was treated with sufentanil combined with Pro intravenous anesthesia,the observation group was treated with Dex combined with Pro intravenous anesthesia.The sedative effect(anesthesia induction time,Ramsay sedation score),gastroscopy related indicators(gastroscopy time,recovery time,propofol dosage),hemodynamic level[heart rate(HR),mean arterial pressure(MAP)],anesthesia adverse reactions and patient satisfaction were compared between the two groups.Results The anesthesia induction time of the observation group was shorter than that of the control group,and the Ramsay sedation score was lower than that of the control group(P<0.05).The gastroscopy time and recovery time of the observation group were shorter than those of the control group,and the dosage of propofol was less than that of the control group(P<0.05).At the time of endoscopy,the levels of HR and MAP in the two groups were lower than those before anesthesia,but the levels of HR and MAP in the observation group were higher than those in the control group(P<0.05).After withdrawal,there was no significant difference in HR and MAP levels between the two groups(P>0.05).The incidence of adverse reactions of anesthesia in the observation group was lower than that in the control group,and the patient satisfaction was higher than that in the control group(P<0.05).Conclusion Dex combined with Pro intravenous anesthesia has a good sedative effect in painless gastroscopy.It has short anesthesia induction time,quick recovery and small hemodynamic fluctuation.Meanwhile,it can reduce the gastroscopy time and propofol dosage of patients,reduce the risk of adverse reactions of anesthesia,and improve patient satisfaction.