摘要
目的观察探讨右美托咪定联合舒芬太尼在无痛肠内镜黏膜下剥离术(ESD)中的应用效果。方法选取2019年1月—2020年12月萍乡市人民医院60例择期行ESD术的患者作为研究对象,采用随机数字表法分为对照组和观察组,每组各30例。对照组采用传统的丙泊酚联合舒芬太尼静脉麻醉;观察组采用右美托咪定联合舒芬太尼静脉麻醉。监测两组患者麻醉诱导前(T0)、给药后2 min(T1)、给药后5 min(T2)、给药后10 min(T3)、给药后30 min(T4)、手术结束时(T5)的呼吸(RR)、心率(HR)、血压(MAP)、脉搏血氧饱和度(SpO2)等指标变化情况,记录手术时间、麻醉诱导时间及术后苏醒时间,观察手术操作过程中的不良反应发生情况和患者的镇痛效果。结果两组在T1~T5时的RR、HR、MAP均低于本组T0时,差异有统计学意义(P<0.05)。两组在T1~T5时的SpO2与T0时比较,差异无统计学意义(P>0.05)。观察组T1~T4时的MAP高于对照组,差异有统计学意义(P<0.05);两组T5时的MAP比较,差异无统计学意义(P>0.05)。两组T1~T5时的RR、HR以及SpO2比较,差异均无统计学意义(P>0.05)。两组的手术时间比较,差异无统计学意义(P>0.05)。观察组麻醉诱导时间长于对照组,但观察组的苏醒时间短于对照组,患者镇痛效果等级优于对照组,差异有统计学意义(P<0.05)。观察组低血压、呼吸抑制及体动反应的发生率以及不良反应总发生率低于对照组,差异有统计学意义(P<0.05)。结论在无痛肠道ESD术中,应用右美托咪定联合舒芬太尼,有更好的镇痛效果,对血流动力学影响较小,且苏醒快,不良反应少,应用效果良好。
Objective To observe and explore the application effect of Dexmedetomidine combined with Sufentanil in painless intestinal endoscopic submucosal dissection(ESD).Methods A total of 60 patients who underwent selective ESD in Pingxiang People′s Hospital from January 2019 to December 2020 were selected as the research subjects.According to the random number table method,they were divided into a control group and an observation group,with 30 cases in each group.Patients in the control group were given traditional intravenous anesthesia of Propofol combined with Sufentanil;while in the observation group,intravenous anesthesia of Dexmedetomidine combined with Sufentanil was used.The respiration(RR),heart rate(HR),mean arterial pressure(MAP),and pulse blood oxygen saturation(SpO2)of the two groups before induction of anesthesia(T0),2 min after administration(T1),5 min after administration(T2),10 min after administration(T3),30 min after administration(T4),and at the end of surgery(T5)were monitored.The operation time,anesthesia induction time and postoperative recovery time were recorded.The occurrence of adverse reactions during the operation and the analgesic effect of patients were observed.Results The RR,HR,and MAP of the two groups at T1-T5 were lower than those of this group at T0,and the differences were statistically significant(P<0.05).There were no significant differences in SpO2 between T1-T5 and T0 between the two groups(P>0.05).The MAP levels of the observation group at T1-T4 were higher than those of the control group,and the differences were statistically significant(P<0.05).There was no statistically significant difference in MAP between the two groups at T5(P>0.05).There were no statistically significant differences in RR,HR and SpO2 between the two groups at T1-T5(P>0.05).There was no statistically significant difference in the operation time between the two groups(P>0.05).The observation group had longer anesthesia induction time than the control group,while the recovery time of the observation group was shorter than that of the control group,and the analgesic effect of patients was also better than that of the control group,with statistical significance difference(P<0.05).The incidence of hypotension,respiratory depression and body movement reactions and total incidence of averse reactions in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).Conclusion In painless intestinal ESD surgery,application of Dexmedetomidine combined with Sufentanil has great analgesic effect,little impact on hemodynamics,quick wake up,and few adverse reactions with a favorable application effect.
作者
肖泽田
XIAO Ze-tian(Department of Anesthesiology,Pingxiang People′s Hospital,Jiangxi Province,Pingxiang337000,China)
出处
《中国当代医药》
CAS
2021年第23期173-176,共4页
China Modern Medicine
基金
江西省卫健委科技立项项目(20204418)。
