右美托咪定喷鼻联合丙泊酚静脉注射在成人肥胖患者无痛胃镜下黏膜切除术中的麻醉效果及对苏醒质量的影响  

Anesthesia effect of dexmedetomidine nasal spray combined with propofol intravenous injection in painless gastroscopy mucosal resection of adult obese patients and its influence on quality of recovery

作　　者：赵静[1] 吴仲烨[1] 李艳[1] ZHAO Jing;WU Zhongye;LI Yan(Yan'an University Affiliated Hospital,Yan'an 716000,China)

机构地区：[1]延安大学附属医院,陕西延安716000

出　　处：《临床医学研究与实践》2022年第14期86-90,共5页Clinical Research and Practice

摘　　要：目的探讨右美托咪定喷鼻联合丙泊酚静脉注射在成人肥胖患者无痛胃镜下黏膜切除术中的麻醉效果及对苏醒质量的影响。方法选取2020年9月至2021年9月我院收治的100例进行无痛胃镜下黏膜切除术的肥胖患者作为研究对象,根据麻醉方案的不同将其分为对照组(50例,丙泊酚静脉注射)和观察组(50例,右美托咪定喷鼻联合丙泊酚静脉注射)。比较两组的麻醉效果。结果T_(2)时,观察组的HR、MAP高于对照组(P<0.05);T_(3)时,观察组的HR、MAP低于对照组(P<0.05)。观察组的苏醒时间和停药至拔管时间均短于对照组,苏醒期最高Ramsay镇静评分、术后呛咳评分及苏醒期躁动评分均低于对照组(P<0.05)。观察组的呛咳、躁动发生率及不良反应总发生率均低于对照组(P<0.05)。拔管时,两组的VAS评分比较,差异无统计学意义(P>0.05);术后2、4 h,观察组的VAS评分均低于对照组(P<0.05)。观察组术中瑞芬太尼和丙泊酚用量均少于对照组(P<0.05)。观察组的麻醉优良率高于对照组(P<0.05)。结论右美托咪定喷鼻联合丙泊酚静脉注射在成人肥胖患者无痛胃镜下黏膜切除术中的麻醉效果显著,能够稳定患者的生命体征,缩短苏醒时间和停药至拔管时间,降低苏醒期Ramsay镇静评分和躁动评分,减轻术后的疼痛程度,降低术后不良反应发生率,值得临床推广和应用。Objective To explore the anesthesia effect of dexmedetomidine nasal spray combined with propofol intravenous injection in painless gastroscopy mucosal resection of adult obese patients and its influence on quality of recovery.Methods A total of 100 obese patients who underwent painless gastroscopy mucosal resection from September 2020 to September 2021 in our hospital were selected as the research subjects,and the patients were divided into control group(50 cases,propofol intravenous)and observation group(50 cases,dexmedetomidine nasal spray combined with propofol intravenous)according to different anesthesia schemes.The anesthetic effects of the two groups were compared.Results At T_(2),the HR and MAP in the observation group were higher than those in the control group(P<0.05);at T_(3),the HR and MAP in the observation group were lower than those in the control group(P<0.05).The recovery time and the time from drug withdrawal to extubation in the observation group were shorter than those in the control group,and the highest Ramsay sedation score during awakening,postoperative cough score and agitation score during awakening were lower than those in the control group(P<0.05).The incidences of cough,agitation and the total incidence of adverse reactions in the observation group were lower than those in the control group(P<0.05).At extubation,there was no significant difference in VAS score between the two groups(P>0.05);at 2 and 4 h after operation,the VAS score in the observation group were lower than those in the control group(P<0.05).The intraoperative dosages of remifentanil and propofol in the observation group were less than those in the control group(P<0.05).The excellent and good rate of anesthesia in the observation group was higher than that in the control group(P<0.05).Conclusion Dexmedetomidine nasal spray combined with propofol intravenous injection in painless gastroscopy mucosal resection of adult obese patients has a significant anesthesia effect,it can stabilize the patients'vital signs,shorten th

关 键 词：右美托咪定 丙泊酚 肥胖 无痛胃镜 黏膜切除术 

分 类 号：R614[医药卫生—麻醉学]