右美托咪定复合丙泊酚用于小儿无痛纤维结肠镜检查的临床观察  

Clinical investigation of propofl combined combined with dexmedetomidine on analgesic in infants with enteroscopy

作　　者：程斌 徐莉 

机构地区：[1]成都市妇女儿童中心医院麻醉科,四川成都610091

出　　处：《四川医学》2013年第1期37-39,共3页Sichuan Medical Journal

摘　　要：目的观察右美托咪定复合丙泊酚用于小儿无痛纤维结肠镜检查的麻醉效果及安全性。方法行纤维结肠镜检查患儿40例,ASAⅠ或Ⅱ级,随机分为右美托咪定复合丙泊酚组(D组)和丙泊酚组(P组),每组20例。D组15min内缓慢静脉注射右美托咪定1μg/kg,再静脉注射丙泊酚2mg/kg;P组静脉注射丙泊酚2.5mg/kg,必要时追加丙泊酚。对两组患儿的麻醉效果评级;观察两组患儿注药前(T0)、注药后5min(T1)、过脾曲时(T2)、过肝曲时(T3)、苏醒时(T4)HR、RR、SBP和SpO2的变化;记录麻醉起效时间、苏醒时间及麻醉后不良反应发生情况。结果 D组镇痛效果优于P组(P<0.05)。T1时两组HR慢于、SBP和SpO2均明显低于T0时(P<0.05)。T2～T4时D组HR慢于、SBP低于P组和T0时(P<0.05)。P组起效、苏醒时间长于D组(P<0.05)。P组丙泊酚用量明显高于D组(P<0.05)。术中舌后坠和呼吸抑制P组明显高于D组(P<0.05)。P组苏醒时头晕、躁动发生率明显高于D组(P<0.05)。结论右美托咪定复合丙泊酚可以安全用于小儿无痛纤维结肠镜检查且麻醉效果满意。Objective To compare the effect and safety of propofol with dexmedetomidine in children with analgesic en- temseopy. Methods Forty ASA of Ⅰ or Ⅱ children aged 2 ～ 8 years undergoing analgesic enteroscopy were randomly allocated to 2 groups：group D was administrated intravenously dexmedetomidine I ug/kg followed by pmpofol 2mg/kg; group P was administra- ted propofol 2. 5mg/kg. The scale of anethetic effect, Ha ,Ra ,SBp and SpO2 at before anesthesia（T0） , 5min after injection（T l）, passing the splenic flexure（ T2 ）, passing the hepatic flexure（T3 ） and awake（ T4 ） were monitored, the time of acting anes- thetics, recovery were recorded, adverse reaction and complication after anesthesia were also recorded. Results The anethetic effect in group D was better tan in group P （ P 〈 0. 05 ）. In two groups, H a ,S BP and S v 0 2 at T i were lower than at T0 （ P 〈 0. 05 ）. The H a and S apof children in group D at T2-T4 were lower than those in group P and at To （ P 〈 0.05 ）. The time of recovery of infants in group P was longer than that in group D（ P 〈 0.05 ）. The incidence of agitation and headache in group P was higher than that in group D （ P 〈 0. 05 ）. The amount of propofol of both was significantly differently between the two groups （ P 〈 0. 05 ）. Conclusion The an- esthetic effect of dexmedetomidine combined with prooofol for children undergoin~ enterosconv is satisfactory and safe.

关 键 词：纤维结肠镜检查 无痛 右美托咪定 丙泊酚 小儿 

分 类 号：R472[医药卫生—护理学]