胃食管反流病射频治疗中右美托咪啶、舒芬太尼、依托咪酯联合应用的麻醉效果

发布时间：2018-04-28 09:48

本文选题：胃食管反流病 + 微量射频术　；参考：《山东医药》2015年39期

【摘要】：目的观察右美托咪啶联合舒芬太尼、依托咪酯用于胃食管反流病微量射频术麻醉中的效果。方法行内镜下微量射频治疗的胃食管反流病患者80例,随机分为A、B组。A组采用右美托咪啶+依托咪酯+舒芬太尼麻醉;B组采用咪达唑仑+依托咪酯+舒芬太尼麻醉。记录给药前(T0)、给药后(T1)、胃镜检查开始(T2)、射频治疗开始(T3)、射频治疗5 min(T4)、10 min(T5)及治疗结束(T6)时患者的SBP、DBP、HR、Sp O2、RR。观察并记录两组手术时间、清醒时间、操作反应、药物追加情况及不良反应发生情况。结果与T0相比,两组给药后HR、Sp O2、SBP、DBP、RR均有下降(P均0.05);A组T2、T3时DBP及T2~T6时HR低于B组,T3、T4时Sp O2高于B组(P均0.05)。A组操作反应少于B组,且治疗中药物追加减少(P均0.05)。A组肌颤、Sp O2下降、呼吸幅度大影响操作、哮喘等不良反应发生情况少于B组(P均0.05),其中B组1例因哮喘发作终止治疗。A组心率降低发生情况多于B组,给予小剂量阿托品后好转。结论胃食管反流病微量射频术中使用右美托咪啶联合舒芬太尼、依托咪酯麻醉效果较好,麻醉不良反应少。
[Abstract]:Objective to observe the effect of dexmetomidine combined with sufentanil and etomidate in microradiofrequency anesthesia for gastroesophageal reflux disease (GERD). Methods Eighty patients with gastroesophageal reflux disease were randomly divided into two groups: group A (n = 80) treated with dexmetomidine etomidate sufentanil (group B) and group B (n = 30) treated with midazolam etomidate sufentanil (group B). Before and after administration of T0, T1, gastroscopy, radiofrequency, 5 min, 5 min and 5 min, respectively, of the patients with SBP, DBP, HRSp, O2-RRs were recorded. The operative time, waking time, operative reaction, drug supplementation and adverse reaction were observed and recorded in the two groups. Results compared with T0, the HR at T2T 3 and T2~T6 in group A were lower than those in group B (P < 0. 05). The operating response of group A was lower than that of group B (P < 0. 05), and that of group A was significantly lower than that of group B (P < 0. 05 or P < 0. 05), while the HR of group T2~T6 was lower than that of group B at T3, T4, respectively. The incidence of adverse reactions such as asthma was less than that of group B (0.05), in which one case in group B had lower heart rate due to the termination of asthma attack. Group A was better than group B in terms of low dose atropine. Conclusion dexmetomidine combined with sufentanil was used during radiofrequency microsurgery for gastroesophageal reflux disease. Etomidate is effective and has less adverse reaction.
【作者单位】：第二炮兵总医院;
【分类号】：R614

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