右美托咪定滴鼻在老年无痛胃肠镜舒适化医疗中的临床应用

Clinical Application of Dexmedetomidine Nasal Drip in Painless Gastroscopy and Colonoscopy Comfort Treatment in the Elderly

摘要: 目的：观察右美托咪定滴鼻在老年无痛胃肠镜舒适化医疗中缓解术前紧张焦虑，减轻注射痛等临床效果。方法：选取2019年1月~12月，我院ASA I~II级，65~80岁，老年无痛胃肠镜患者120例，分为右美托咪定组(D组，n = 60例)和对照组(C组，n = 60例)。D组于检查前15分钟鼻内滴入0.6 μg/kg右美托咪定，C组鼻内滴入同等容积的生理盐水，两组均静脉注射1~1.5 mg/kg丙泊酚至患者意识、体动消失后进行内镜操作，检查完毕后送恢复室进行常规监护。结果：D组老年患者术前紧张导致的血压增高较C组明显降低(P < 0.05)；D组丙泊酚注射痛发生率较C组明显降低(P < 0.05)；D组丙泊酚用量较C组明显减少(P < 0.05)。结论：右美托咪定滴鼻可以有效缓解老年无痛胃肠镜术前紧张焦虑情绪，减轻丙泊酚注射痛，并减少丙泊酚用量，缩短苏醒时间和离院时间，增加麻醉安全性及舒适性。

Abstract: Objective: To explore the clinical effect of dexmedetomidine nasal drops in relieving preoperative tension and anxiety and relieving injection pain in painless gastroscopy and colonoscopy comfort treatment for the elderly. Methods: From January to December 2019, 120 elderly patients with ASA I - II, aged 65 - 80 years and painless gastroscopy and colonoscopy were divided into two groups: group D (n = 50) and control group (n = 50). The patients were divided into two groups: dexmedetomidine group (group D, n = 60) and control group (group C, n = 60). Group D was intranasally injected with 0.6 μg/kg dexmedetomidine 15 min before examination, and group C was intranasally injected with the same volume of normal saline. Both groups were intravenously injected with 1 - 1.5 mg/kg propofol until the consciousness and movement of the patients disappeared, and endoscopic operation was performed. After the examination, they were sent to the recovery room for routine monitoring. Results: The increase of blood pressure caused by preoperative tension in group D was significantly lower than that in group C (P < 0.05). The incidence of injection pain caused by propofol in group; D was significantly lower than that in group C (P < 0.05). The induction dose of propofol anesthesia in group; D was significantly lower than that in group C (P < 0.05). Conclusion: In senile painless gastroenteroscopy, dexmedetomidine nasal drip can effectively relieve preoperative tension and anxiety, reduce injection pain caused by propofol, reduce the dose of propofol, shorten awakening time and discharge time, and increase the safety and comfort of anesthesia.