右美托咪啶复合小剂量氯胺酮用于肠镜下治疗的效果观察  

Application of dexmedetomidine combined with small doses of ketamine used for treatment under colonoscopy

作　　者：许峰[1] 郭斌[1] 李熹[1] 

机构地区：[1]解放军第123医院麻醉科,安徽蚌埠233015

出　　处：《淮海医药》2015年第1期8-9,共2页Journal of Huaihai Medicine

摘　　要：目的观察右美托咪定复合小剂量氯胺酮用于肠镜下治疗的安全性及可行性。方法选取需行肠镜下治疗患者60例,随机分为2组,每组30例。其中D组患者使用右美托咪定复合氯胺酮麻醉;P组患者使用异丙酚复合芬太尼麻醉。观察并记录2组患者注药前(T1)、置入肠镜(T2)、操作结束(T3)、苏醒(T4)等时点的MAP、HR、SPO2,以及操作总时间(T)和完全清醒需要的时间(Tw);记录有无低血压、缓慢心率、呼吸抑制等不良反应。结果 D组患者术前、术中、术后、苏醒时MAP、HR、SPO2变化较P组平稳,且完全清醒时间要短于P组,低血压、缓慢心率和呼吸抑制发生率也要低于P组,2者比较差异均有差异性(P值均小于0.05)。结论对于肠镜下治疗需要较长时间镇静麻醉的手术,使用右美托咪定复合小剂量氯胺酮可以稳定患者术中的生命体征,且苏醒时间和苏醒质量优于异丙酚复合阿片麻醉,是一种比较安全理想的麻醉方式。Objective To investigate the safety and feasibility of dexmedetomidine （DEX）combined with small doses of ketamine used for treatment under colonoscopy. Methods A total of 60 patients were randomly divided into two groups. The patients in group D received vein anesthesia using DEX combined with katemine during the treatment under colonoscopy while those in group P received vein anesthesia using propofol combined with fentanyl. The respiratory and circulation indices, and adverse effects were observed and compared between the two groups. Results The respiratory and circulation fluctuation in group D were significantly smoother than those in group P （ P 〈 0.05 ） , and the adverse effect was lower in group D than that in group P. Conclusion The vein anesthesia using DEX combined with small doses of ketamine used for treatment under colonoscopy is safe and feasible,which is better for patients with instability of circulation.

关 键 词：右美托咪定 小剂量氯胺酮 电子肠镜 治疗 

分 类 号：R574[医药卫生—消化系统]