Comparative study of different dosages of dexmedetomidine combined with fentanyl for monitored anesthesia care during endoscopic variceal ligation
10.3760/cma.j.issn.1007-5232.2016.06.010
- VernacularTitle:不同剂量右美托咪定复合芬太尼用于食管静脉曲张内镜下套扎术监护性麻醉的对比研究
- Author:
Kai LI
;
Jun ZOU
;
Jingpeng JIN
;
Yang LIU
;
Longyun LI
;
Bin ZHANG
- Publication Type:Journal Article
- Keywords:
Endoscopic variceal ligation;
Dexmedetomidine;
Monitored anesthesia care
- From:
Chinese Journal of Digestive Endoscopy
2016;33(6):388-392
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the ideal dosage of dexmedetomidine( DEX) with 1?0 μg/kg fentanyl for monitored anesthesia care ( MAC) during endoscopic variceal ligation ( EVL) . Methods A total of 60 patients scheduled for elective EVL were randomly divided into 3 groups ( n=20) . After fentanyl was infused intravenously at the dosage of 1?0 μg/kg, the loading dosage of DEX at 1?0 μg/kg ( group D1 ) , 1?5 μg/kg ( group D2 ) , or 2?0μg/kg ( group D3 ) was continuously infused in 10 min, respectively. When the modified OAA/S score reaching≥3 point, EVL was carried out. The change in modified OAA/S score, the operation duration time, recovery time, satisfaction rates of patient and doctor, and complications were recorded. Results There were no significant differences in regarding of general status, operation duration time and satisfaction score of patients between the 3 groups ( P>0?05 ) . Before endoscope insertion, the OAA/S score in group D3(4?4±0?2)was higher than that in D1(3?4±0?5)or D2 groups(3?8±0?3)(P<0?05), and there was no significant difference between the scores of D1 and D2(P>0?05).At the time?point of 5 mins after endoscope insertion, the OAA/S score in group D3(4?5±0?3)was significantly higher than that in D1(3?5±0?6)or D2 groups(3?7±0?4)(P<0?05),there were no significant differences between D1 and D2( P>0?05) . At the end of the procedure,there was no significant difference in OAA/S score between the 3 groups(P>0?05).Compared with group D1(3?1±0?9)min and D2(3?8±0?8)min, the recovery time in group D3(6?6±1?2)min was significantly longer (P<0?05), while there was no significant difference between D1 and D2(P>0?05). The satisfaction score of endoscopist in group D1(8?0±0?8) was significantly lower than that in group D2(9?4±0?6)or D3(9?5±0?5)(P<0?05), there was no significant difference between groups D2 and D3 ( P>0?05 ) . No tachycardia, hypertension or hypoxemia occurred during the procedure. There was no significant difference in rate of hypotension among the three groups ( P>0?05) . The incidences of nausea(30%) and body movement(15%) in group D1 were significantly higher than those in group D2 and D3(P<0?05).There were no differences between D2 and D3(P>0?05). The incidence of bradycardia in group D3(40%) was significantly higher than those in group D1(0) and D2(10%)(P<0?05).There were no differences between those in D1 and D2(P>0?05). Conclusion Combined with 1?0 μg/kg fentanyl, 1?5 μg/kg DEX is more efficient and safer for EVL in the status of MAC.
