中国医科大学学报2024，Vol.53Issue(1)：39-45,7.DOI:10.12007/j.issn.0258-4646.2024.01.007
静脉输注右美托咪定联合靶控输注瑞芬太尼在老年患者ERCP麻醉中的临床应用
Clinical application of intravenous dexmedetomidine combined with target-controlled remifentanil in anesthesia of ERCP surgery in older adult patients
摘要
Abstract
Objective To explore the safety and feasibility of intravenous dexmedetomidine(Dex)combined with targeted infusion of remifentanil in endoscopic retrograde cholangiopancreatography(ERCP)anesthesia in older adult patients.Methods From January to August 2021,98 older adult patients(≥65 years old)undergoing ERCP were randomly divided into TRP and TRD groups.The TRP group was anesthetized with target-controlled infusion of propofol and remifentanil and the TRD group was treated with Dex combined with target-controlled infusion of remifentanil.mean arterial pressure(MAP),heart rate(HR),electrocardiogram(ECG),respiratory rate(RR),pulse oxygen saturation(SpO2),bispectral index(BIS)before anesthesia induction(T0),immediately after induction of anesthesia(T1),endoscopic introduction(T2),duodenal papilla intubation(T3),endoscopy withdrawal(T4)and postoperative awakening(T5)were observed.Arterial blood gas analysis at different time points(T0,every 15 min after anesthesia induction and T5),PaO2,and PaCO2,were recorded at the above mentioned time points;and the remifentanil concentration in target-controlled infusion,operation time,recovery time(from infusion of remifentanil to consciousness recovery),anesthesia recovery time(from consciousness recovery to leaving the operating room),intraoperative body movement,Aldrete scores out of the room,Visual Analogue Scale(VAS)at 60 min after surgery,occurrence of post-operative adverse reactions,as well as the satisfaction of anesthesiologists,endoscopists,and patients were recorded.Results Compared with the TRP group,MAP at T1 and T3,SpO2 and RR at T1,T2,T3,and T4,and BIS at T2,T3,T4,and T5 increased,whereas HR at T1,T2,T3,and T4 decreased;the number of mandibular rests,incidence of hypoxemia,Aldrete score,and satisfaction increased,whereas the VAS score at 60 min after surgery decreased in the TRD group(P<0.05).There were no statistically significant differences in postoperative adverse reactions,PaO2 and PaCO2,target-controlled infusion remifentanil concentration,operation time,recovery time,and anesthesia recovery time between the two groups.Conclusion Compared with the target-controlled infusion of propofol-remifentanil,intravenous infusion of Dex combined with target-controlled infusion of remifentanil can reduce the incidence of hypoxemia in older adult patients during ERCP surgery,and the anesthesia regimen can meet the anesthesia needs of ERCP surgery,which is safe and feasible.关键词
靶控输注/瑞芬太尼/丙泊酚/右美托咪定/内镜逆行胰胆管造影术/老年Key words
target controlled infusion/remifentanil/propofol/dexmedetomidine/endoscopic retrograde cholangiopancreatography/older adult分类
医药卫生引用本文复制引用
陈宁,宋丹丹,裘治慧,徐明,崔波,刁玉刚..静脉输注右美托咪定联合靶控输注瑞芬太尼在老年患者ERCP麻醉中的临床应用[J].中国医科大学学报,2024,53(1):39-45,7.基金项目
辽宁省民生科技计划(2021JH2/10300011) （2021JH2/10300011）
