右美托咪定复合丙泊酚在膀胱镜检查术中的应用  

Application of Combined Dexmedetomidine -Propofol Anesthesia in Cystoscopy

作　　者：何凌锋[1] 袁建国[2] 童建成[2] 

机构地区：[1]武汉大学基础医学院,湖北武汉430071 [2]武警湖北总队医院麻醉科,湖北武汉430075

出　　处：《医学新知》2013年第1期25-27,共3页New Medicine

摘　　要：目的探讨右美托咪定复合丙泊酚用于膀胱镜检查术麻醉的有效性和安全性。方法60例ASAI或Ⅱ级拟行膀胱镜检术的患者，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30例。D组先缓慢输注右美托咪定0．6μg/kg，15min内输完，随后静脉注射丙泊酚2．0-2．5mg／kg，术中必要时追加丙泊酚0．5-1．0mg／kg维持麻醉深度；P组先缓慢输注0．9％氯化钠10ml，15min内输完，余处理同D组。记录两组患者麻醉诱导前（T0）、诱导后2min（T1）、镜检5min（T2）、术毕清醒时（T3）的心率（HR）、平均动脉压（MAP）、脉搏氧饱和度（SpO2）变化；记录两组患者镜检时间、麻醉苏醒时间和丙泊酚总用量，以及不良反应发生情况，并术后评估麻醉效果。结果两组患者麻醉均满意，检查时间和苏醒时间没有差异，丙泊酚总用量D组少于P组（P〈0．05）。组内比较，P组T1和T2时MAP和Sp02低于T0时（P〈0．05），D组T1和T2时SpO2低于T0时（P〈0．05）；组间比较，T1和T2时D组患者MAP和SpO2高于P组（P〈0．05）；P组舌后坠、呼吸抑制、低血压和体动反应的发生率高于D组（P〈0．05），心动过缓的发生率两组间没有差异（P〉0．05）。结论右美托咪定复合丙泊酚用于膀胱镜检查术麻醉效果满意，呼吸循环稳定，应用安全。Objective To investigate the effectiveness and safety of combined dexmedetomidine - propofol anes- thesia in cystoscopy. Methods Sixty patients （ ASA Ⅰ orⅡ ） undergoing cystoscopy were randomly assigned to two groups. Group D （n = 30）was intravenously administrated with dexmedetomidine 0.6 μg/kg in 15 minutes followed by propofol 2.0 -2.5 mg/kg;group P（n = 30）was intravenously given 10 ml of 0.9% saline in 15 minutes followed by propofol 2.0 - 2.5 mg/kg. Propofol 0.5 -1.0 mg/kg was used to maintain the depth of anesthesia when necessary. Heart rate（ HR）, mean artery pressure（MAP） and pulse oxygen saturation（ SpO2 ）were measured at 4 time points：be- fore anesthesia（T0 ）,2 minutes after injection （T1 ）, 5 minutes during examination （T2 ）and the time of emergence （T3 ）. The duration of examination, emergence time, doses of propofol and adverse reactions were recorded. The de- grees of patient satisfaction were measured. Results There were no significant difference in the degree of patient sat- isfaction, the duration of examination and recovery time between two groups. The doses of propofol in group D were less than those in group P（ P 〈 0.05 ）. In group P, MAP and SpO2 at T1 and T2 were lower than that at To （ P 〈 0. 05 ） ; in group D, SpO2 at T1 and T2 were lower than that at To （P 〈 0.05）. MAP and SpO2 at T1 and T2 in group D were higher than those in group P （ P 〈 0.05 ）. The incidence of glossocoma, respiratory depression, hypotension and body move- ment in group P were higher than those in group D. The incidence of bradycardia was the same in both group （P 〉 0. 05 ）. Conclusion Combined dexmedetomidine - propofol anesthesia for patients undergoing cystoscopy is satisfac- tory and safety.

关 键 词：右美托咪定 丙泊酚 膀胱镜 麻醉 

分 类 号：R614.24[医药卫生—麻醉学]