右美托咪定与瑞芬太尼分别联合七氟烷在内镜逆行性胰胆管造影中的应用效果

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Abstract Objective To compare the efficacy of Dexmedetomidine and Remifentanil combined with Sevoflurane in endoscopic retrograde cholangiography (ERCP). Methods A total of 80 elective ERCP patients admitted to Fujian Provincial Hospital South Branch from March 2019 to February 2020 were selected as the study subjects, and divided into Dexmedetomidine (DEX) group (40 cases) and Remifentanil (REMI) group (40 cases) according to computer random number method.In DEX group,DEX 0.8 μg/kg was pumped 10 min before induction of anesthesia,DEX 0.2 g/(kg·h) was maintained during surgery,and pumping was stopped 10 min before the end of surgery.In the REMI group, 2.5 μg/(kg·h)REMI was pumped from 10 min before induction of anesthesia to the end of surgery. Postoperative pain intensity, postoperative analgesia needs, incidence of adverse reactions, postoperative recovery, extubation time, anesthesia time and Sevoflurane usage were compared between the two groups. The hemodynamic change of two groups were compared before drug pumping (T0), 10 min after drug pumping (T1), immediately after endotracheal intubation (T2), 1 min after intubation (T3), immediately after operation (T4), 15 min after operation (T5), when entering the post-anesthesia monitoring treatment room (T6), immediately after extubation (T7), 1 min after extubation (T8). Results There were no significant differences in postoperative pain intensity, analgesic need, incidence of adverse reactions, postoperative awakening, extubation time and anesthesia time between two groups (P＞0.05). The Sevoflurane dose and dose per unit time in DEX group were lower than those in REMI group, and the differences were statistically significant (P＜0.05). In terms of hemodynamic changes, blood pressure at T3 and T4 in DEX group was lower than that in REMI group, heart rate at T2-T8 in DEX group was lower than that in REMI group, and the differences were statistically significant (P＜0.05). There were no significant differences in blood pressure and heart rate between the two groups at other time points (P＞0.05). Conclusion Low-dose Dexmedetomidine is used for ERCP treatment and is equivalent to Remifentanil. However, Dexmedetomidine can reduce intraoperative stress induced hemodynamic fluctuations and the need for inhalation anesthesia, and can be safely used as an alternative adjuvant to Remifentanil.

Key words： Dexmedetomidine Remifentanil Endoscopic retrograde cholangiopancreatography Sevoflurane Visual analogue scale

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	Articles by authors
	YU Xiao-fang
	JIANG Li-feng
	HUANG Xue-ping
	HUANG Jian-min

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YU Xiao-fang,JIANG Li-feng,HUANG Xue-ping, et al. Effect of Dexmedetomidine and Remifentanil combined with Sevoflurane in endoscopic retrograde cholangiopancreatography[J]. 中国当代医药, 2021, 28(28): 114-117-125.

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http://dangdaiyiyao.com/EN/ OR http://dangdaiyiyao.com/EN/Y2021/V28/I28/114

[1]	李鹏，王拥军，王文海.中国经内镜逆行胰胆管造影术指南（2018 版）[J].临床肝胆病杂志，2018，34（12）：2537-2554.
[2]	金晨昱.持续输注右美托咪定和瑞芬太尼的荟萃分析[D].上海：上海交通大学，2019.
[3]	莫伟波，黎必万.右美托咪定在全身麻醉中的应用进展[J].吉林医学，2012，33（31）：6850-6853.
[4]	赵振海，王华.右美托咪定在临床围术期的器官保护作用研究进展[J].医学综述，2018，24（1）：90-94.
[5]	马波，刘志恒，王显春.右美托咪定镇痛的临床应用进展[J].临床麻醉学杂志，2018，34（11）：1136-1139.
[6]	陈理建，丛海涛，梁慧英.右美托咪定对腹腔镜胆囊切除术患者神经损伤标志物及术后认知功能的影响[J].中国现代医生，2020，58（11）：127-130.
[7]	Gazi M，Abitagaoglu S，Turan G，et al.Evaluation of the effects of dexmedetomidine and remifentanil on pain with the analgesia nociception index in the perioperative period in hysteroscopies under general anesthesia：A randomized prospective study[J].Saudi Med J，2018，39（10）：1017-1022.
[8]	林海荣，邱晨.BIS 监测下右美托咪啶复合丙泊酚和瑞芬太尼在妇科腔镜手术中的应用及对麻醉效果的影响[J].中国医学创新，2020，17（12）：70-74.
[9]	许淑秋.右美托咪啶对上腹部手术患者术后镇痛及芬太尼使用量的影响[J].现代实用医学，2019，31（11）：1474-1475.
[10]	张伟.右美托咪啶用于高血压患者麻醉的研究进展[J].中国城乡企业卫生，2020，35（5）：59-61.
[11]	杨进斌.右美托咪啶和瑞芬太尼对经口气管插管血流动力学的影响[J].广州医药，2019，50（4）：30-34.
[12]	乔昕，王炼，艾攀，沈文振.右美托咪啶在老年高血压患者手术麻醉中应用研究进展[J].中国实验诊断学，2018，22（11）：2034-2037.
[13]	蒋琦，王丛慧.瑞芬太尼对不同年龄组患者心血管功能抑制的研究[J].临床医药文献电子杂志，2017，4（58）：11290-11294，11297.
[14]	蔡弥松.不同阿片类药物对老年非心脏手术患者血流动力学及心血管事件的影响[J].中国老年学杂志，2014，34（20）：5756-5758.
[15]	曹蕾，闵红星，高改莉.丙泊酚麻醉诱导时复合不同剂量的瑞芬太尼对患者心血管的影响[J].宁夏医学杂志，2007，4（2）：156-157.
[16]	程文杰，徐桂萍.瑞芬太尼的心血管副作用机制与临床意义[J].国际麻醉学与复苏杂志，2013，4（4）：324-326.
[17]	王淑辉，刘丽波，叶苗青.右美托咪啶复合麻醉对结肠癌根治术患者术中血流动力学及术后氧化应激和肠道屏障功能的影响[J].中国医师杂志，2020，22（12）：1778-1781.
[18]	Arcangeli A，D′Alo C，Gaspari R.Dexmedetomidine use in general anaesthesia[J].Curr Drug Targets，2009，10（8）：687-695.
[19]	葛蕾，谢文静.右美托咪啶复合舒芬太尼对腹腔镜肝癌或胰腺癌治疗术患者心动过缓、心动过速、低血压的影响[J].包头医学院学报，2019，35（10）：24-25.
[20]	吴升浩.右美托咪啶静脉泵注复合七氟烷吸入麻醉在妇科腹腔镜手术麻醉中应用效果[J].临床合理用药杂志，2020，13（2）：78-79，98.
[21]	朱志鹏，周清河，吴军民，肖旺频，朱长玉.右美托咪啶对小儿七氟烷吸入全麻的影响[J].中国中西医结合外科杂志，2012，18（3）：251-254.