小剂量异丙酚复合右美托咪定在脑血管造影术中的应用

目的探讨小剂量异丙酚复合右美托咪定在脑血管造影术中镇静的有效性和安全性。方法局麻下择期行脑血管造影术的患者60例，随机分为3组，每组20例，分别采用小剂量异丙酚复合右美托咪定（P—D组）、异丙酚（P组）和氟哌利多一芬太尼合剂（C组）镇静。观察并记录镇静给药前（R）、给药后5min（T1）、给药后15min（T2）、给药后30min（T3）、术后5min（T4）、术后30min（T5）等时间点的平均动脉压（MAP）、心率（HR）、呼吸频率（RR）、Ramsey镇静评分及SpO2值。结果三组患者T1～T4时MAP、HR均明显低于T0时（P〈0．05）；C组T2～T3时、P组T1～T3时SpO2明显低于T0（P〈0．05）；三组患者T1～T3时Ramsay评分均显著高于R时（P〈0．05）。组间比较，P—D组、P组在T1-T4时MAP和HR明显低于C组（P〈0．05），P—D组患者R～B时SpO2显著高于C组（P〈0．05）。T2-T4时P—D组患者Ramsay评分显著低于c组（P〈0．05）。C组并发症显著多于P组和P—D组（P〈0．01），C组和P组术中的总干预次数明显多于P～D组（P〈0．05）。结论小剂量异丙酚复合右美托咪定用于脑血管造影术中镇静安全、有效。

Application of low-dose propofol combined with dexmedetomidine to patients with cerebrovascular disease during the procedure of cerebral angiography

Objective To explore the anesthesia effect of low-dose propofol combined with dexmedetomidine （DXM） on. the patients with cerebrovascular disease during the procedure of cerebral angiography and their security. Methods Sixty patients with cerebrovascular disease were divided into three groups, i.e. group A （n=20）, group B （n=20） and group C （n=20）. The low-dose propofol combined with DXM was used for anesthesia and sedation during the procedure of cerebral angiography in group A. The propofol and the innovar were used in group B and group C respectively. Heart rate （HR）, mean arterial pressure （MAP）, SpO2, respiratory rate （RR） and scores of Ramsey sedation scale were recorded hefore anesthesia （T0）, 5 mitt （T1）, 15 min （T2） and 30 rain （T3） after the attesthesia and 5 rain （T4） and 30 min （T5） after the angiography. Results The MAP and the HR at T1-T4 in all the groups, the SpO2 at T2-T3 in group C and the SpO2 at T1-T3 in group B were significantly lower than those at To （P〈0.05）. The Ramsey scores at T1-T3 were significantly higher than those at To in three groups （P〈0.05）, but the RR did not significantly change at any time point in three groups （P〉0.05）. The MAP and the HR at T1-T4 in group A and group B were significantly lower than those in group C （P〈0.05）. The SpO： at T2-T3 in group A were significantly higher than those in group C （P〈0.05）, and the Ramsey scores at T2-T4 in group A were significantly lower than those in group C （P〈0.05）. The incidence of the complication was significantly higher in group C than those in group A and group B （P〈0.01）. Conclusions Application of low-dose propofol combined with DXM to patients with cerebrovascular disease during the procedure of cerebral angiography is safe and their anesthesia and sedation effects are good.