监测麻醉用于门诊患者无痛肠镜检查的临床观察  

Clinical Observation of Monitoring Anesthesia for Painless Enteroscopy in Outpatients

作　　者：杨学锋[1] 刘君 耿茁[1] 杨晨[1] YANG Xuefeng;LIU Jun;GENG Zhuo;YANG Chen(Department of Anesthesiology,First People's Hospital of Yinchuan,Yinchuan 750001,China)

机构地区：[1]银川市第一人民医院麻醉科,银川750001

出　　处：《宁夏医科大学学报》2020年第5期510-513,共4页Journal of Ningxia Medical University

摘　　要：目的探讨监测麻醉用于无痛肠镜检查的可行性。方法选择2017年1月-2018年1月在监测麻醉下行门诊无痛肠镜检查的60例患者,随机分为丙泊酚复合舒芬太尼组(A组)30例和右美托咪定复合舒芬太尼组(B组)30例,观察两组患者检查前、检查中、检查完毕后的血压、心率(HR)、血氧饱和度(SPO2)、双频谱脑电图(BIS)值和改良镇静/警觉评分(OAA/S)的变化情况;记录两组患者检查完毕后的睁眼时间和完成指令动作时间;同时记录内脏牵拉反应程度和检查后患者满意度情况、麻黄碱和阿托品的使用以及术中自动配合手术体位的情况。结果检查中A组患者的血压、HR、SPO2、BIS值和OAA/S评分均低于B组(P均<0.05),检查完毕后A组患者的血压、SPO2、BIS值和OAA/S评分均低于B组,HR高于B组,睁眼时间和完成指令动作时间均较B组长(P均<0.05)。A组患者苏醒后内脏牵拉反应0级30例(100%);B组患者内脏牵拉反应0级28例(93%)。术后满意度:A组评价为3分的患者24例(80%),B组27例(90%)。结论右美托咪定复合舒芬太尼监测麻醉用于门诊无痛肠镜的检查安全、有效,可在临床推广。Objective To explore the feasibility of monitoring anesthesia for painless enteroscopy.Methods Sixty patients enrolled from January 2017 to January 2018 who scheduled for painless enteroscopy were randomly divided into propofol combined sufentanil group(group A,n=30)and dexmedetomidine combined with sufentanil group(group B,n=30).The changes of blood pressure,heart rate,oxygen saturation,BIS value and OAA/S score were observed before,during and after the examination.At the same time,the degree of visceral traction reaction and patients'satisfaction after examination were recorded.The number of cases of ephedrine and atropine use and the number of intraoperative auto-operative postures were recorded.Results In the examination,the blood pressure,HR,SPO2,BIS,OAA/S of group A were significantly lower than those in group B(P all<0.05).After the examination,the blood pressure,SPO2,BIS,OAA/S of group A were significantly lower than those in group B,(P all<0.05).HR of group A were significantly higher than group B(P<0.05).After the examination,the time of eyes opening in group A was longer than that of group B(P all<0.05).In group A,0 grade,30 patients(100%)were asked about the visceral traction reaction.In group B,0 grade was 28 patients(93%),24 patients(80%)in group A and 27 patients(90%)in group B were assessed 3 points of postoperative satisfaction.Conclusion Monitoring anesthesia with dexmetomidine combined with sufentanil is safe and effective for painless enteroscopy in out-patient clinic.

关 键 词：监测麻醉 无痛肠镜 检查 

分 类 号：R614.2[医药卫生—麻醉学]