右美托咪定复合瑞芬太尼在胃镜检查中的应用
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摘要
目的观察右美托咪定复合瑞芬太尼用于胃镜检查中的麻醉效果。方法将拟行胃镜检查对象90例,按随机数字表法分为A组、B组,A组采用右美托咪定+瑞芬太尼复合麻醉;B组采用右美托咪定+舒芬太尼复合麻醉。观察患者的生命体征在检查过程中各时间节点的变化情况、不良反应发生率、入睡时间、苏醒时间、总滞留时间以及相关满意度。结果 A组患者的生命体征变化在胃镜检查过程中显著低于B组(P<0.05);不良反应发生率低于B组(15.6%比48.9%,χ2=11.447,P<0.05);两组患者入睡时间、苏醒时间在麻醉给药后,A组显著低于B组(P<0.05);但两组患者的镜检时间、总滞留时间差异无统计学意义(P>0.05);A组患者满意度明显高于B组(P<0.05)。结论右美托咪定复合瑞芬太尼用于无痛胃镜检查,患者生命体征更趋稳定、不良反应发生率较低、苏醒时间较短、患者满意度较高。
Objective To observe the anesthetic effects of dexmetomidine combined with remifentanil in painless gastroscopy. Methods Ninty patients with painless gastroscopy were randomized into group A and B. Patients in group A were given dexmetomidine and remifentanil,and the group B were given dexmetomidine and sufentanil. The pertaining to the changes of vital signs in the examination,the incidence of adverse reactions,time of falling asleep,waking up and leaving hospital as well as patients' satisfaction were observed in two groups of patient. Results The changes of vital signs and incidence of adverse reactions of group A were obvious lower than those of group B. The fall asleep upon anesthesia and earlier wake-up after examination of group A were obvious shorter than group B( all P < 0. 05). The two groups were no significant between two group in the time of examination and the time to leave hospital( P > 0. 05). Patients' satisfaction rates of group A were higher than group B( P < 0. 05). Conclusion Dexmetomidine combined with remifentanil can maintain stable vital signs,reduce the adverse reactions,shorten the wake-up and improve the satisfaction of patients.
Objective To observe the anesthetic effects of dexmetomidine combined with remifentanil in painless gastroscopy. Methods Ninty patients with painless gastroscopy were randomized into group A and B. Patients in group A were given dexmetomidine and remifentanil,and the group B were given dexmetomidine and sufentanil. The pertaining to the changes of vital signs in the examination,the incidence of adverse reactions,time of falling asleep,waking up and leaving hospital as well as patients' satisfaction were observed in two groups of patient. Results The changes of vital signs and incidence of adverse reactions of group A were obvious lower than those of group B. The fall asleep upon anesthesia and earlier wake-up after examination of group A were obvious shorter than group B( all P < 0. 05). The two groups were no significant between two group in the time of examination and the time to leave hospital( P > 0. 05). Patients' satisfaction rates of group A were higher than group B( P < 0. 05). Conclusion Dexmetomidine combined with remifentanil can maintain stable vital signs,reduce the adverse reactions,shorten the wake-up and improve the satisfaction of patients.
引文
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[10]吕淑仙.小剂量瑞芬太尼复合丙泊酚用于胃肠镜检查的可行性探讨[J].世界临床医学,2016,10(13):23.
[11]肖兴鹏,贾一帆,余奇劲,等.脑电双频指数指导无痛胃镜检查中瑞芬太尼最适剂量的选择[J].国际麻醉学与复苏杂志,2017,38(7):605-607.
[2]刘诗稳,钟声宏.右美托咪定对预防无痛胃镜检查中引起呛咳的临床观察[J].现代诊断与治疗,2016,27(16):3013-3014.
[3]HONG Y J,JIANG E H,HE J H,et al.Effect of midazolam on memory during fiberoptic gastroscopy under conscious sedation[J].Clin Neuropharmacol,2015,38(2):47-51.
[4]苏明萍.探析右美托咪定在无痛胃镜麻醉中的应用价值[J].医药前沿,2016,30(6):28-29.
[5]刘鲲鹏,廖旭,薛富善.舒芬太尼的药理学和临床应用[J].中国医药导刊,2005,7(6):454-457.
[6]刘金娥,何伟.静脉应用瑞芬太尼与芬太尼在高龄患者手术麻醉中的临床对比分析[J].中国医药指南,2012,10(9):147-148.
[7]万里,王云,王庚,等.区域麻醉镇静辅助用药专家共识[M]//中国麻醉学指南与专家共识(2017).北京:人民卫生出版社,2017:198-205.
[8]饶立新,王瑞英,袁薇,等.不同剂量右美托咪定复合丙泊酚-瑞芬太尼对肝功能异常患者腹部手术的麻醉效果[J].医学综述,2017,23(4):805-808.
[9]齐爱玲,李月鹏,陈晓东,等.咪达唑仑复合瑞芬太尼在无痛胃镜检查中的应用研究[J].中国医药导刊,2015,17(1):44-47.
[10]吕淑仙.小剂量瑞芬太尼复合丙泊酚用于胃肠镜检查的可行性探讨[J].世界临床医学,2016,10(13):23.
[11]肖兴鹏,贾一帆,余奇劲,等.脑电双频指数指导无痛胃镜检查中瑞芬太尼最适剂量的选择[J].国际麻醉学与复苏杂志,2017,38(7):605-607.