右美托咪定复合靶控输注（TCI）异丙酚用于肥胖患者无痛肠镜的研究
发布时间：2018-07-20 12:04
【摘要】：目的:本研究旨在探讨小剂量右美托咪定(Dexrnedetomidine,Dex)复合靶控输注(Traget controlled infusin,TCI)三种不同预设血浆浓度异丙酚用于肥胖患者无痛肠镜检查术的麻醉效果及安全性,寻求一个适宜肥胖患者的方案。方法:行无痛肠镜检查术的患者90例,性别不限,美国麻醉评分(American Society of Anesthesiolgist,ASA)Ⅰ级或Ⅱ级,年龄30~50岁,BMI 28~32 kg/m2,采用随机数字表法,将患者随机分为:生理盐水对照组(P组,n=45)和Dex组(DP组,n=45),麻醉前15 min DP组静脉注射Dex负荷剂量0.3μg/kg,10min注射完,随后复合TCI异丙酚按预设血浆靶浓度2,3,4μg/ml分为DP1,DP2,DP33个亚组(n=15),P组麻醉前给予等容量生理盐水,麻醉时按TCI异丙酚预设血浆靶浓度2,3,4μg/ml分为P1,P2,P3 3个亚组(n=15),观察记录术前(T0)、用Dex或安慰剂后第10min(T1)、用异丙酚意识消失后(T2)、检查开始1min(T3)、检查开始5min(T4)、检查结束时(T5)、唤醒时(T6)7个时间点,记录脑电双频指数(Bisperctra in dex,BIS)、平均动脉压(Mean arterial pressure,MAP)、心率(Heart rate,HR)、呼吸频率(Respiratory rate,RR)和脉搏血氧饱和度(Pulse blood oxygen saturation,SPO2)。并观察体动、心动过缓、低血压、呼吸抑制、低氧血症、恶心呕吐、反流误吸、呛咳、术中知晓等不良反应,记录苏醒质量以及离院评分情况。结果:与P1组相比,DP1组无需追加异丙酚、血流动力学更稳定,无呼吸抑制发生,无体动反应,苏醒质量好以及离院评分高(P0.05)。与DP2和DP3组相比,DP1组异丙酚用量最小,血流动力学更稳定,无呼吸抑制发生,苏醒质量高,离院评分高(P0.05)。单纯使用异丙酚组(P1—3)出现呛咳,而使用Dex各组(DP1—3)均未出现呛咳(P㩳0.05,差异有统计意义)。各组均无恶心呕吐、反流误吸和术中知晓等不良反应。结论:在维持一定的麻醉深度前提下,Dex(负荷剂量0.3μg/kg)复合TCI异丙酚(预设血浆靶浓度为2μg/ml),对于肥胖患者无痛肠镜检查麻醉效果确切安全。
[Abstract]:Objective: to investigate the anesthetic efficacy and safety of low dose Dexrne de tomidineine Dex (Dexrne dex) combined with target controlled infusion (TCI) with three different preset plasma concentrations of propofol for painless enteroscopy in obese patients. Look for a plan for obese patients. Methods: ninety patients with painless enteroscopy, regardless of sex, were enrolled in this study. Their American Society of anaesthesia grade 鈪，
本文编号：2133458
[Abstract]:Objective: to investigate the anesthetic efficacy and safety of low dose Dexrne de tomidineine Dex (Dexrne dex) combined with target controlled infusion (TCI) with three different preset plasma concentrations of propofol for painless enteroscopy in obese patients. Look for a plan for obese patients. Methods: ninety patients with painless enteroscopy, regardless of sex, were enrolled in this study. Their American Society of anaesthesia grade 鈪，
本文编号：2133458
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