右美托咪定(DEX)复合丙泊酚用于无痛胃镜检查的临床效果及安全性

 目的 观察右美托咪定(dexmedetomidine,DEX)复合丙泊酚用于无痛胃镜检查的临床效果及安全性。方法 选择2011年1月至6月在浙江大学医学院附属第二医院内窥镜检查中心行胃镜检查的患者65例,电脑随机法分成对照组(P组,n＝33)、实验组(D组,n＝32),入室开放上肢静脉,吸氧,监测血压、心率、血氧饱和度,D组静脉推注DEX (0.1 μg·kg-1·min-1),P组静脉推注安慰剂(0.9%生理盐水)3 mL,之后两组均静脉推注丙泊酚(2 mg·kg-1·min-1),完成后开始插镜,检查中如有体动反应,追加丙泊酚30～50 mg,并观察丙泊酚用量及体动、循环、呼吸抑制等不良反应。结果 丙泊酚总用药量P组明显高于D组 (P<0.05);D组体动发生例数明显低于P组(P<0.05);用丙泊酚实施无痛麻醉过程中均可导致循环抑制,而且DEX对此效能有协同作用(P<0.05)。结论 小剂量DEX在无痛胃镜中的使用方法简单,且具有良好的安全性; 能协同丙泊酚的麻醉镇静作用,提供更佳的术中镇静效果。

Safety and efficacy of dexmedetomidine (DEX) combined with propofol for patients undergoing painless gastroscope

Objective A clinical study was conducted to investigate the safety and efficacy of dexmedetomidine(DEX) combined with propofol for sedation of patients undergoing painless gastroscope.Methods Sixty five patients with ASA 1 2 requiring gastroscopic were randomized to received DEX 0.1 μg/kg (group D,n=32) or saline placebo (group P,n=33) initial loading dose,followed by propofol 2 mg/kg.According to the body activity and operation time,whether to add propofol 30 mg～50 mg or not.Full recovery time,operation time,the consumed dose of propofol,mean arterial pressure (MAP),heart rate (HR),hemoglobin oxygen saturation levels(SPO2) were recorded.Results The trend of SPO2,HR and MAP were similar in both groups,but MAP in group D decreased to lower than that in group P at the time point of intravenous administration of propofol and 1 min after intravenous admintistraton of propofol (P<0.05).The rate of the body activity and the consumed dose of propofol were lower in group D (P<0.05).Conclusions There were more efficacy and safe for DEX combined with propofol for sedation of patients undergoing painless gastroscope.