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右美托咪定在单气囊小肠镜诊疗术中的应用
作者:孙艳玲 吴五洲 许先成 
单位:湖北医药学院附属十堰市太和医院麻醉科
关键词:右美托咪定 单气囊小肠镜 麻醉诱导 血流动力学 
分类号:
出版年·卷·期(页码):2013·41·第五期(329-332)
摘要:

【摘要】目的 探讨右美托咪定用于单气囊小肠镜诊疗术的有效性和安全性。 方法  ASAⅠ~Ⅱ级择期行单气囊小肠镜诊疗的患者30例,随机分为右美托咪定组(D组)和生理盐水对照组(C组)。D组单次给予以0.9%氯化钠溶液稀释的盐酸右美托咪定注射液0.6μg/kg,经静脉泵输入的时间为10min。C组用等体积的0.9%氯化钠溶液替换右美托咪定注射液。给药完毕后观察10min,两组均以静脉持续泵注丙泊酚维持麻醉。观察记录两组患者入室、微泵持续泵注右美托咪啶10min时、气管插管即刻、置入小肠镜和气管拔管时各时段SBP、DBP和HR变化,患者丙泊酚诱导剂量、诱导时间、术中维持麻醉时丙泊酚用量和拔管时间(从手术结束至拔除气管导管),记录术中合并用药情况和术后不良反应发生的情况。结果  与C组相比,D组诱导时间、苏醒时间明显缩短(P<0.05),麻醉诱导、术中丙泊酚用量明显少于C组(P<0.05);与入室时比较,置入小肠镜时和拔管时C组血压明显升高、心率明显增快(P<0.05),D组血压、心率无明显变化。两组患者苏醒期躁动、术中窦性心动过缓、低血压的发生率的比较无统计学差异(P>0.05)。 结论 右美托咪定用于单气囊小肠镜诊疗术可明显缩短麻醉诱导时间,使患者围术期血流动力学更稳定,减少麻醉药物的使用,术后苏醒迅速而完全,而无明显不良反应,可以安全有效的应用。

【Abstract】Objective To investigate the safety and efficacy of dexmedetomidine in Single-balloon enteroscopy. Methods thirty patients ASA gradeⅠorⅡ, scheduled for Single-balloon enteroscopy were randomly assigned to two groups: group D ( intravenous perfusion of dexmedetomidine 0.6μg/kg),group C (normal saline of equal volume with dexmedetomidine ),each group had fifteen cases. Group D and group C respectively received dexmedetomidine and normal saline before induction by ways of intravenous infusion (the duration of infusion was ten minutes). Then general anesthesia was induct-ed by perfusion of propofol,intravenous injection of fentanyl and vecuronium..The maintainence of anesthesia used by propofol intravenous injection in both two groups. Patients blood pressure, heart rate and spo2 were recorded at the time of entering the operating room, intravenous infusion after 10 minutes, intubation, insertion of Single-balloon enteroscopy and extubation. Results Compared with group D, at the time of intubation, insertion of Single-balloon enteroscopy and extubation, the blood pressure and heart rate of group C were significantly increased (P<0.05). In group C, the blood pressure and heart rate at the time of intubation, insertion of Single-balloon enteroscopy and extubation were significantly increased compared with basic (P<0.05). Compared with group C,patients in group D falled sleep faster with significant lower dose of propofol (P<0.05). The time of anesthesia awake in group D was decreased significantly than in group C (P<0.05). Conclusion Perfusion of dexmedetomidine with 0.6μg/kg for 10 minutes before induction presented more stable during the whole period of induction.,It also reduces the dosis of propofol in the period of induction. and operation. Dexmedetomidine can make patients hemodynamics more stable and the recovery more rapid and complete.

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