现代消化及介入诊疗
現代消化及介入診療
현대소화급개입진료
MODERN DIGESTION & INTERVENTION
2014年
5期
297-299
,共3页
右美托咪定%瑞芬太尼%监测麻醉%无痛肠镜
右美託咪定%瑞芬太尼%鑑測痳醉%無痛腸鏡
우미탁미정%서분태니%감측마취%무통장경
Dexmedetomidine%Remifentanil%Monitored anesthesia care (MAC)%Painless colonoscopy
目的：探讨右美托咪定复合盐酸瑞芬太尼MAC用于无痛肠镜中的可行性与安全性。方法将60例自愿行无痛肠镜检查患者随机分为DR组（右美托咪定复合瑞芬太尼组）和DP组（右美托咪定复合丙泊酚组），每组30例。两组患者均先缓慢注入右美托咪定0.6滋g/kg，时间大于10 min。DR组注射完毕后给予盐酸瑞芬太尼1.0滋g/kg，时间大于1 min，然后以0.1滋g·kg-1·min-1持续静脉泵注。DP组注射完毕后给予丙泊酚1.5～2.0滋g/kg。记录基础值（T0）、检查开始（T1）、手术结束（T2）、术毕10 min（T3）各个时间点的血压、心率、脉搏血氧饱和度（SpO2）、Ramsay镇静评分；苏醒时间（术毕至呼之睁眼）；并发症包括恶心、呕吐、呼吸抑制、头晕等。结果两组患者均顺利完成手术，DR组Ramsay镇静评分明显低于DP组（P<0.05），血流动力学更平稳（P<0.05），副作用小。结论右美托咪定复合盐酸瑞芬太尼MAC可安全用于无痛肠镜，血流动力学稳定，副作用小。
目的：探討右美託咪定複閤鹽痠瑞芬太尼MAC用于無痛腸鏡中的可行性與安全性。方法將60例自願行無痛腸鏡檢查患者隨機分為DR組（右美託咪定複閤瑞芬太尼組）和DP組（右美託咪定複閤丙泊酚組），每組30例。兩組患者均先緩慢註入右美託咪定0.6滋g/kg，時間大于10 min。DR組註射完畢後給予鹽痠瑞芬太尼1.0滋g/kg，時間大于1 min，然後以0.1滋g·kg-1·min-1持續靜脈泵註。DP組註射完畢後給予丙泊酚1.5～2.0滋g/kg。記錄基礎值（T0）、檢查開始（T1）、手術結束（T2）、術畢10 min（T3）各箇時間點的血壓、心率、脈搏血氧飽和度（SpO2）、Ramsay鎮靜評分；囌醒時間（術畢至呼之睜眼）；併髮癥包括噁心、嘔吐、呼吸抑製、頭暈等。結果兩組患者均順利完成手術，DR組Ramsay鎮靜評分明顯低于DP組（P<0.05），血流動力學更平穩（P<0.05），副作用小。結論右美託咪定複閤鹽痠瑞芬太尼MAC可安全用于無痛腸鏡，血流動力學穩定，副作用小。
목적：탐토우미탁미정복합염산서분태니MAC용우무통장경중적가행성여안전성。방법장60례자원행무통장경검사환자수궤분위DR조（우미탁미정복합서분태니조）화DP조（우미탁미정복합병박분조），매조30례。량조환자균선완만주입우미탁미정0.6자g/kg，시간대우10 min。DR조주사완필후급여염산서분태니1.0자g/kg，시간대우1 min，연후이0.1자g·kg-1·min-1지속정맥빙주。DP조주사완필후급여병박분1.5～2.0자g/kg。기록기출치（T0）、검사개시（T1）、수술결속（T2）、술필10 min（T3）각개시간점적혈압、심솔、맥박혈양포화도（SpO2）、Ramsay진정평분；소성시간（술필지호지정안）；병발증포괄악심、구토、호흡억제、두훈등。결과량조환자균순리완성수술，DR조Ramsay진정평분명현저우DP조（P<0.05），혈류동역학경평은（P<0.05），부작용소。결론우미탁미정복합염산서분태니MAC가안전용우무통장경，혈류동역학은정，부작용소。
Objective To explore the feasibility and safety of dexmedetomidine and remifentanil for painless colonoscopy. Method Sixty patients scheduled for painless colonoscopy were randomly divided into Group DR(dexmedetomidine combined with remifentanil)and Group DP(dexmedetomidine combined with propofol), 30 patients for each group. Intravenous injection of dexmedetomidine was done with a dosage of 0.6μg/kg within 10 minutes for all patients in the two groups. Remifentanil was given with a dosage of 1.0μg/kg within 1 minute and then remifentanil was given with a dosage of 0.1μg·kg-1·min-1 by continuous intravenous infusion for patients in Group DR. While for patients in Group DP, after intravenous injection of dexmedeto-midine with a dosage of 0.6μg/kg within 10 minutes, propofol was injected with a dosage of 1.5~2.0μg/kg. The mean blood pressure, heart rate, pulse oxygen saturation(SpO2), and Ramsay sedation score at the time of base value (T0), check the start (T1), end of the operation (T2), and 10 minutes post operatively (T3) were recorded; recovery time (end of the operation to called the open eyes) and complications including nausea, vomiting, respiratory inhibition and dizziness were also recorded. Result Two groups of patients were suc-cessfully completed the operation, and Ramsay sedation score in group DR was significantly lower than that in group DP (P<0.05). Compared with group DP, MAP and HR in group DR was more stable (P<0.05), the side effects in group DR were less. Conclusion Dexmedetomidine combined with remifentanil MAC can be safely used in painless colonoscopy.
