右美托咪定复合丙泊酚在无痛肠镜检查中的应用

目的：观察右美托咪定复合丙泊酚用于无痛肠镜检查的临床效果及安全性。方法：选择用肠镜检查患者66例，随机分成二组P组（n＝33）、D组（n＝33），入室开放上肢静脉,吸氧，监测血压、心率、血氧饱和度，D组先0.1μg/kg/min静脉推注右美托咪定（0.1μg/kg），P组静脉推注安慰剂（0.9%生理盐水）3ml后，再2 mg/kg/min静脉推注丙泊酚（1.5 mg/kg）,完成后待睫毛反射消失，开始插镜，检查中如有体动反应，追加丙泊酚30～50mg，并观察丙泊酚用量，及体动，循环、呼吸抑制等副作用。结果：丙泊酚总用药量，可唤醒时间P组明显高于D组，差异有统计学意义（ p〈0.05）；D组体动发生例数明显低于P组，差异有统计学意义（p〈0.05）；用丙泊酚实施无痛麻醉过程中均可导致循环抑制，心率加快，右美托咪定对循环影响小，能导致心率降低，可拮抗丙泊酚的心率加快作用，差异有统计学意义p〈0.05。结论：小剂量右美托咪定在无痛肠镜中的使用，方法简单，具有良好的安全性; 能协同丙泊酚的麻醉镇静作用，提供更佳的术中镇静效果。

Application of dexmedetomidine combined with propofol used for painless enteroscope

AIM： To investigate the safety and efficacy of dexmedetomidine （DEX） com- bined with propofol for sedation of patients undergoing painless enteroscope. METHODS： Six- ty six patients with ASA I-II requiring entero- scope were randomized to （Group D, n=33） and （Group P, n=33）. After venous passway was conducted, the mean arterial pressure （MAP）, heart rate（HR）, hemoglobin oxygen saturation levels（SpO2） were recorded. Group D received DEX 0.1 μg/kg and Group P received saline pla- cebo 3 mL initial loading dose, followed by propofol 1.5 mg/kg,according to the body activ- ity and operation time, whether to add propofol 30--50 mg or not. And the consumed dose of propofol, the body movement response, respira- tory depression were recorded. RESULTS： Compared with Group D, the total administered dose of propofol, the time of patients awaken, the body activity in Group P were increased. During the painless anesthesia, propofol could lead to the circulation inhibition and the heartbeat was significantly quickened. Dexmedetomidine has little influence on the circulation, but it induced the decreased of heart rate. CONCLUSION： There were more efficacy and safe for DEX com- bined with propofol for sedation of patients un- dergoing painless enteroscope.