南方医科大学学报
南方醫科大學學報
남방의과대학학보
JOURNAL OF SOUTHERN MEDICAL UNIVERSITY
2015年
2期
264-267
,共4页
吉锦泉%王刚%孙柯%周国斌%王志鹏%王妍
吉錦泉%王剛%孫柯%週國斌%王誌鵬%王妍
길금천%왕강%손가%주국빈%왕지붕%왕연
右美托咪定%Narcotrend麻醉深度监测%结肠息肉切除术
右美託咪定%Narcotrend痳醉深度鑑測%結腸息肉切除術
우미탁미정%Narcotrend마취심도감측%결장식육절제술
dexmedetomidine%narcotrend monitoring%colonic polyps resection
目的:探讨Narcotrend麻醉深度监测下右美托咪定复合丙泊酚在无痛结肠镜结肠息肉切除术中对患者生命体征及麻醉深度的影响。方法选择无痛结肠镜患者90例随机分成Dex组(D)组和对照组(C)组各45例,入室开放上肢静脉,吸氧,监测血压、心率、脉氧饱和度和麻醉深度指数(NTI)。D组缓慢静脉泵注(10 min)右美托咪定0.3μg/kg,然后注射丙泊酚1 mg/kg;C组单独静脉注射丙泊酚2 mg/kg。检查中如有体动反应,追加丙泊酚0.2~0.5 mg/kg。观察丙泊酚用量、可唤醒时间及体动、循环、呼吸抑制等不良反应。结果丙泊酚总用药量和呼吸抑制例数D组明显低于C组(P<0.05);体动发生例数D组明显低于C组(P<0.05);循环抑制例数两组无明显差异(P>0.05);麻醉深度指数(NTI)C组明显低于D组(P<0.05)。结论 Narcotrend麻醉深度监测下右美托咪定复合丙泊酚同单独使用丙泊酚相比能达到更合理的麻醉深度以减少不良反应,并能提供更佳的镇痛效果且大大降低丙泊酚用量。
目的:探討Narcotrend痳醉深度鑑測下右美託咪定複閤丙泊酚在無痛結腸鏡結腸息肉切除術中對患者生命體徵及痳醉深度的影響。方法選擇無痛結腸鏡患者90例隨機分成Dex組(D)組和對照組(C)組各45例,入室開放上肢靜脈,吸氧,鑑測血壓、心率、脈氧飽和度和痳醉深度指數(NTI)。D組緩慢靜脈泵註(10 min)右美託咪定0.3μg/kg,然後註射丙泊酚1 mg/kg;C組單獨靜脈註射丙泊酚2 mg/kg。檢查中如有體動反應,追加丙泊酚0.2~0.5 mg/kg。觀察丙泊酚用量、可喚醒時間及體動、循環、呼吸抑製等不良反應。結果丙泊酚總用藥量和呼吸抑製例數D組明顯低于C組(P<0.05);體動髮生例數D組明顯低于C組(P<0.05);循環抑製例數兩組無明顯差異(P>0.05);痳醉深度指數(NTI)C組明顯低于D組(P<0.05)。結論 Narcotrend痳醉深度鑑測下右美託咪定複閤丙泊酚同單獨使用丙泊酚相比能達到更閤理的痳醉深度以減少不良反應,併能提供更佳的鎮痛效果且大大降低丙泊酚用量。
목적:탐토Narcotrend마취심도감측하우미탁미정복합병박분재무통결장경결장식육절제술중대환자생명체정급마취심도적영향。방법선택무통결장경환자90례수궤분성Dex조(D)조화대조조(C)조각45례,입실개방상지정맥,흡양,감측혈압、심솔、맥양포화도화마취심도지수(NTI)。D조완만정맥빙주(10 min)우미탁미정0.3μg/kg,연후주사병박분1 mg/kg;C조단독정맥주사병박분2 mg/kg。검사중여유체동반응,추가병박분0.2~0.5 mg/kg。관찰병박분용량、가환성시간급체동、순배、호흡억제등불량반응。결과병박분총용약량화호흡억제례수D조명현저우C조(P<0.05);체동발생례수D조명현저우C조(P<0.05);순배억제례수량조무명현차이(P>0.05);마취심도지수(NTI)C조명현저우D조(P<0.05)。결론 Narcotrend마취심도감측하우미탁미정복합병박분동단독사용병박분상비능체도경합리적마취심도이감소불량반응,병능제공경가적진통효과차대대강저병박분용량。
Objective This clinical study was conducted to investigate the effects of dexmedetomidine (DEX) combined with propofol on vital signs and anaesthetic depth in patients. Methods Ninty patients with ASA 1-2 requiring painless colono-scopy for colonic polyps resection were randomized to receive DEX 0.3μg/kg (group D, n=45) followed by propofol 1 mg/kg or propofol 2 mg/kg (group C, n=45), and according to the body activity and operation time, additional doses of propofol (0.2-0.5 mg/kg) were given. The full recovery time,operation time, consumed dose of propofol, mean arterial pressure(MAP), heart rate (HR), hemoglobin oxygen saturation levels(SPO2) and NTI were recorded.Results The SPO2、recover time and the consumed dose of propofol in group D were decreased compared to those in group C (P<0.01). The rate of the body activity in group D was lower than that in group C (P<0.05). The NTI in group C was lower than that in group D (P<0.05). The HR and MAP were similar in both groups. Conclusion Under Narcotrend monitoring, the value of DEX combined with low dose of propofol in colonoscopy for colonic polyps resection is to reach more reasonable depth of anesthesia to reduce adverse responses and the dose of propofol.