右美托咪定复合血浆靶控输注丙泊酚用于肥胖患者肠镜检查术的效果  

Effect of the target-controlled infusion of propofol combined with dexmedetomidine on analgesic in obese patients with painless enteroscopy

作　　者：黎冉[1] LI Ran(Department of Anesthesiology, the Second Affiliated Hospital, Fujian Medical University , Quanzhou , Fujian 362000, Chin)

机构地区：[1]福建医科大学附属第二医院麻醉科,泉州362000

出　　处：《福建医药杂志》2018年第2期21-24,共4页Fujian Medical Journal

摘　　要：目的观察右美托咪定(Dex)复合血浆靶控输注(TCI)不同浓度丙泊酚用于肥胖患者肠镜检查术的麻醉效果和安全性。方法90例肠镜检查患者(ASAⅠ~Ⅱ级,年龄24~58岁,BMI 30~32kg/m^2)随机分为两组各45例:M组(生理盐水+丙泊酚)和DM组(0.3μg/kg右美托咪定+丙泊酚),每组再按随后复合TCI丙泊酚的血浆靶浓度2.0、2.5、3.0μg/mL分为M_1,M_2,M_33个亚组(n=15)及DM_1,DM_2,DM_33个亚组(n=15)。观察记录MAP、HR、脑电双频指数(BIS)和SpO_2。观察体动、循环、呼吸等体征,记录不良反应、苏醒质量以及离院评分情况。结果与M_1组相比,DM_1组血流动力学更稳定无呼吸抑制、体动反应发生,苏醒质量好以及离院评分高(P<0.05)。与DM_2和DM_3组相比,DM_1组镇静深度合适,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(P<0.05)。结论0.3μg/kg右美托咪定复合血浆TCI 2μg/mL丙泊酚对于肥胖患者肠镜检查术麻醉效果确切、安全性高。Objective To evaluate the effect and safety with target-controlled infusion of propofol combined with dexmedetomidine on indolent enteroscope for obese patients.Methods Ninety patients with ASA Physical statusⅠ-Ⅱ,aged 24-58,BMI：30-32 kg/m^2,scheduled for general surgey were randomly allocated into normal saline combined with Propofol group or dexmedetomidine combined with Propofol group with 45 case each.The obesity geriatric patients in each group were randomly assigned into three subgroups（n=15 each）,both blank control group M1-3 and groups DM1-3（receieved iv infusion of dexmedetomidine 0.3μg/kg at a rate of 0.05μg/（kg·min）receieving TCI of propofol with the target plasma concentration set at2.0,2.5 and 3.0μg/mL respectively at 15 min after the end of infusion.The scale of anesthetic effect,MAP,HR,BIS and SpO2 including the movement,bradycardia,hypotension,respiratory,nausea,regurgitation and aspiration,analepsia quality,departure scores were recorded.Results The anthetic effect in group DM1 was better in group M1（P〈0.05）.Compared with M1 group,DM1 group blood drug concentration was stable and able to maintain enough depth of sedation,more stable hemodynamics,respiratory inhibition was not occurred,no body dynamic response,the wake up good quality as well as from the departure score（P〈0.05）.Compared with DM2 and DM3 groups,dosage of propofol minimally was more stable hemodynamics,respiratory inhibition was not occurred,to high quality and score（P〈0.05）.Conclusion Maintain a certain depth of anesthesia in the premise,Dex（loading dose of 0.3μg/kg）composite TCI propofol（target plasma concentration of 2μg/mL）,for obese patients undergoing enteroscopy is satisfactory and safety.

关 键 词：右美托咪啶 丙泊酚 肠镜 肥胖 靶控输注 

分 类 号：R614[医药卫生—麻醉学]