右美托咪定联合丙泊酚在无痛胃肠镜检查中的镇痛效果评价  

Evaluation of the analgesic effect of dexmedetomidine combined with propofol in painless gastroenteroscopy

作　　者：邱淑杰 张莉 QIU Shu-jie;ZHANG Li(Gaomi People's Hospital,Weifang 261500,China)

机构地区：[1]高密市人民医院,261500

出　　处：《中国现代药物应用》2025年第6期29-33,共5页Chinese Journal of Modern Drug Application

摘　　要：目的分析无痛胃肠镜检查中右美托咪定联合丙泊酚的镇痛效果。方法选取116例进行无痛胃肠镜检查的患者作为研究对象,按照奇偶数法分为对照组和研究组,每组58例。对照组实施单一丙泊酚干预,研究组实施右美托咪定联合丙泊酚干预。对比两组患者麻醉相关指标[麻醉起效时间、苏醒时间、体动反应次数、丙泊酚用量、视觉模拟评分法(VAS)评分]、不同时间点生命体征[心率(HR)、血氧饱和度(SaO2)、平均动脉压(MAP)]、检查前后应激指标[皮质醇(Cor)、肾上腺素(E)、去甲肾上腺素(NE)]、不良反应发生情况。结果研究组麻醉起效时间(85.37±16.22)s、苏醒时间(8.76±1.59)min较对照组的(102.65±19.73)s、(10.98±1.53)min更短,体动反应次数(0.83±0.19)次较对照组的(1.29±0.21)次更少,丙泊酚用量(146.87±28.65)mg、VAS评分(1.04±0.26)分较对照组的(198.52±25.79)mg、(1.45±0.67)分更低(P<0.05)。两组检查前、检查5 min时、检查后5 min的HR、SaO2、MAP水平对比,差异无统计学意义(P>0.05);研究组检查开始时的HR(72.65±8.50)次/min、SaO2(98.71±0.73)%、MAP(86.43±8.30)mm Hg(1 mm Hg=0.133 kPa)较对照组的(66.31±9.14)次/min、(97.89±1.34)%、(79.19±7.33)mm Hg更高(P<0.05)。两组患者检查后的Cor、E、NE均较检查前升高,但研究组患者的Cor(23.49±3.78)μg/L、E(224.96±12.75)pg/ml、NE(269.48±21.76)pg/ml较对照组的(25.63±3.49)μg/L、(235.86±13.05)pg/ml、(283.57±22.14)pg/ml更低(P<0.05)。研究组不良反应发生率为8.62%,较对照组的22.41%更低(P<0.05)。结论对接受无痛胃肠镜检查的患者实施右美托咪定联合丙泊酚干预能够取得更好的麻醉及镇痛效果,且可稳定患者生命体征及应激指标,具有效果良好、安全性高等优势,可于临床推广应用。Objective To analyze the analgesic effect of dexmedetomidine combined with propofol in painless gastroenteroscopy.Methods A total of 116 patients undergoing painless gastroenteroscopy were selected as the study subjects and divided into control group and study group according to odd and even number method,with 58 cases in each group.The control group received single propofol intervention,and the study group received dexmedetomidine combined with propofol intervention.Both groups were compared in terms of anesthesia related indexes[anesthesia onset time,recovery time,frequency of somatic motor responses,propofol dosage,visual analogue scale(VAS)score],vital signs[heart rate(HR),blood oxygen saturation(SaO_(2),mean arterial pressure(MAP)]at different time points,stress indexes[cortisol(Cor),epinephrine(E)],norepinephrine(NE)]before and after examination,and occurrence of adverse reactions.Results The anesthesia onset time and recovery time were(85.37±16.22)s and(8.76±1.59)min,which were shorter than(102.65±19.73)s and(10.98±1.53)min in the control group;the frequency of somatic motor responses of(0.83±0.19)times in the study group was less than(1.29±0.21)times in the control group;the propofol dosage and VAS score were(146.87±28.65)mg and(1.04±0.26)points in the study group,which were lower than(198.52±25.79)mg and(1.45±0.67)points in the control group(P<0.05).There was no significant difference in HR,SaO_(2) and MAP levels between the two groups before examination,after 5 min of examination and 5 min after examination(P>0.05).The study group had HR of(72.65±8.50)beats/min,SaO_(2) of(98.71±0.73)%,and MAP of(86.43±8.30)mm Hg(1 mm Hg=0.133 kPa)at the beginning of examination,which were higher than(66.31±9.14)beats/min,(97.89±1.34)%,and(79.19±7.33)mm Hg in the control group(P<0.05).After examination,Cor,E and NE in both groups were higher than those before examination;the study group had Cor of (23.49±3.78) μg/L, E of (224.96±12.75) pg/ml and NE of (269.48±21.76) pg/ml, which were lower than (25.63

关 键 词：右美托咪定 丙泊酚 无痛胃肠镜检查 镇痛效果 应激指标 

分 类 号：R614[医药卫生—麻醉学]