右美托咪定复合舒芬太尼和异丙酚在无痛肠镜中的应用

目的观察右美托咪定复合异丙酚和舒芬太尼用于无痛肠镜的可行性。方法ASAI-Ⅱ的预约无痛肠镜患者，随机分为右美托咪定复合舒芬太尼和异丙酚组（D）和生理盐水复合异丙酚和舒芬太尼组（N）组，每组15例。常规开放静脉后，D组给予右美托咪定（国药准字H20090251）1μg／ks持续输注15min后再给予异丙酚1mg／kg和舒芬太尼0．2μs／kg，然后以0．5μg／kg持续输注右美托咪定直至检查完毕。N组给予Ns持续输注15rain后给予异丙酚2mg／kg和舒芬太尼0．2μs／kg，对两组患者进行镇痛镇静评级，分别记录两组患者给药前（T0）、给药后1min（T1）、过脾区（T2）及苏醒时（T3）的SBP、HR、SpO2、RSS的变化和术后VAS评分。结果两组镇痛效果差异无统计学意义（P〉0．05）。D组镇静效果优于N组且D组呼吸抑制发生率优于N组（P〈0．05）。D组苏醒离院时间明显短于N组，但D组心率在T1时明显低于T0时。结论右美托咪定复合舒芬太尼用于无痛肠镜的检查可以获得满意的效果但要注意心动过缓的发生。

Applications of dexmedetomidine combined with sufentanli and propofol in painless colonoscop

Objective To observe the feasibility of dexmedetomidine be combined with sufentanil and propafol in paineless colonoscopy. Methods Thirty patients of ASA I - ]l who undergoing painless colonoscopy were randomly divided into two group. Fifteen patiens per group. After conventional open vein, D group received dexmedetomindine continuous infusion before scheduled 1 μg/kg given sufentanil 0.2μg/kg and propofol 1 mg/ kg,then continuous infusion dexemedetomindine 0. 5 μg/kg until over the operation. N group received saline continuous infusion then ggiven propofol 2 mg/kg and sufentanil 0. 2 μg/kg. Two groups of patients with sedation rating. Two groups d patients were recorded on two groups of patients before administration （ T0）, after admin- istration of 1 vain （ T1 ）, through the spleen （ T1）, and wake time （ T3 ） of SBP, HR, SpO2, RSS changes anal- gesic sedation rating. Results There were no significant analgesic effect difference （P 〉 0. 05 ）. D group sedative effect than N group D group and the incidence of respiratory depression than N group （ P 〈 0. 05 ）. Group D awakening from hospital was significantly shorter in group P, but group D when the heart rate was significantly lower than To, T1. Conclusion Dexmedetomidine combined with sufentanil for painless colonoscopy examination can obtain satisfactory results but pay attention to the occurrence of hradycardia.