摘要
目的观察右美托咪定复合舒芬太尼应用于肥胖患者无痛胃镜检查清醒镇静的效果。方法选取2022年1月至2022年5月新疆维吾尔自治区人民医院消化内镜中心行无痛胃镜检查的肥胖患者100例。采用随机数字表法将患者分为2组,每组患者50例。右美托咪定复合舒芬太尼组(D组)给予右美托咪定1μg/kg+舒芬太尼0.1μg/kg,丙泊酚复合舒芬太尼组(P组)给予丙泊酚0.5~0.8 mg/kg+舒芬太尼0.1μg/kg。记录麻醉前、进镜时、诱导3 min、检查结束时的收缩压(SBP)、舒张压(DBP)、心率(HR),血氧饱和度(SpO_(2))<95%和<90%的发生率、胃镜检查时间、镇静相关事件发生率、患者及内镜医师满意度评分。结果D组SPO_(2)<95%和<90%的发生率(22.0%和10.4%)显著低于P组(50.0%和30.6%);与麻醉诱导前比较,进镜时、诱导3 min、检查结束时2组患者SBP、DBP、HR均下降,P组下降较明显(P<0.05%)。2组改中/深度镇静率分别为4.0%和26%(P=0.02)。患者及内镜医师满意度评分D组较P组高(P<0.05)。结论右美托咪定复合舒芬太尼用于肥胖患者无痛胃镜检查清醒镇静效果好,低氧发生率更低,维持血流动力学稳定,镇静成功率高,患者及内镜医师满意度高。
Objective To analyse the effects of conscious sedation with dexmedetomidine and sufentanil in obese patients gastroscopy.Methods The 100 obese patients who underwent painless gastroscopy at the Gastrointestinal Endoscopy Centre of People's Hospital of Xinjiang Uygur Autonomous Region from January 2022 to May 2022 were selected.The patients were divided into 2 groups using the random number table method,with 50 patients in each group.The dexmedetomidine compound sufentanil group(group D)was given dexmedetomidine 1μg/kg+sufentanil 0.1μg/kg,and the propofol compound sufentanil group(group P)was given propofol 0.5-0.8 mg/kg+sufentanil 0.1μg/kg.The SBP、DBP and HR were recorded before anesthesia,at the time of entry into the scope,during the 3 min of induction and at the end of gastroscopy,the incidence of SpO_(2) values<95%and<90%,the operation time,the incidence of sedation-related events,the satisfaction scores of patients and endoscopist were recorded.Results The incidences of SpO_(2)<95%and<90%in group D(22.0%and 10.4%)were significantly lower than those in group P(50.0%and 30.6%,with P=0.004 and 0.003,respectively).Compared with the time before anesthesia,SBP,DBP,HR of the two groups immediately inserting、3 min after induction and gastroscopy end-point were both lower,group P were significantly lower(P<0.05%).The incidence of changing in moderate or deep sedation was 4.0%and 26%between group D and group P(P=0.02).Compared with group P,patient satisfaction scores and endoscopist satisfaction scores were significantly higher in group D(P<0.05).Conclusion The conscious sedation with dexmedetomidine and sufentanil in obese patients gastroscopy is effective,can reduce the incidence of hypoxia、maintain hemodynamic stability、high sedation success rate、high satisfaction of patient and gastroscopy procedure.
作者
喇宏玲
李育耕
阿里木江·司马义
徐桂萍
苏涛
La Hongling;Li Yugeng;A Limijiang·Simayi;Xu Guiping;Su Tao(Department of Anesthesiology,People's Hospital of Xinjiang Uygur Autonomous Region.Xinjiang Clinical Research Center for Anesthesia Management,Urumqi 830001,China)
出处
《中华胃食管反流病电子杂志》
2023年第2期77-81,共5页
Chinese Journal Of Gastroesophageal Reflux Disease(Electronic Edition)
基金
新疆维吾尔自治区人民医院院内项目(20200312)
关键词
肥胖
无痛胃镜
清醒镇静
右美托咪定
丙泊酚
Obese
Painless gastroscopy
Conscious sedation
Dexmedetomidine
Propofol
