Observe The Effect Of Midazolam And Dexmedetomidine In Sedation Of Endoscopy

Objective:By observing the influence on circular breathing system of Dexmedetomidine and Midazolam's conscious sedation anesthesia in the gastroscopy,Comprehensive discussion about the feasibility and application value of the application of conscious sedation anesthesia of Dexmedetomidine and Midazolam in the course of gastroscopy.Methods:Research contents included patients who accepted gastroscopy in endoscope center of Yunnan Second Hospital from July 2016 to December 2016.A total of 147 patients who accepted gastroscopy were selected and they were divided into three groups at random,including 49 patients in each group.The administered group included midazolam(group A)and dexmedetomidine(group B).The control group was local dyclonine anesthesia group(group C).Before examination,all patients took conventional local anesthetics(dyclonine hydrochloride mucilage).The whole process check of ECG monitoring and low flow nasal catheter oxygen.Before examination,all patients in group A and group B established a channel of superficial veins in the forearm.Midazolam and dexmedetomidine were diluted by using conventional normal saline.Before 2min of examination,patients in Group A injected 0.025-0.05mg/kg of midazolam intravenously.Patients in group B were injected with dexmedetomidine at 1?g/kg capacity with a venous pump for more than 10min.In operation,they were maintained at the dosage of 0.2-0.8ug·kg-1·h-1.Before operation,patients in both groups were given with different initial dosage according to their age and physical status.In the examination,according to patients' mind,response,calm depth,blood pressure,pulse,oxygen saturation,breathing,and cooperative situation,dosage was adjusted suitably.Different adverse reactions,narcotic drug administration time,dosage,reaction after dosing of patients in each group(group A and group B)were recorded.As operation,the ECG monitor was used to monitor and record blood pressure,heart rate,and oxygen saturation of patients in each group as hospitalization(T1),instant after finishing dosing(group A and group B),starting to end of examination(T3)and end of examination(T4)continuously.Ramsay scoring was used to score calm effects for the drug group.After dosing,patients cooperated with scoring.Their memory in operation,discomfort in examination and their satisfaction for the calm mode,as well as microscopic examination acceptance were scored.Results:1.Basic situations of respondents:gender,age,height,weight,BMI and ASA grading of all respondents had no statistical difference.2.In the examination process,investigation comparison after examination:For patients in three groups,response and operation duration of patients in three groups had no difference.VAS system scoring in group A and group B was superior to group C.coordinated scoring in operation in group A and group B was superior to group C.The forgotten situation in the examination process in group A was higher to group B.The comfort satisfaction in the examination in group A and group B was superior to group C.group A and group B had no difference.Acceptability of gastroscope in the same mode in group A and group B were superior to group C.Group A and group B had no difference.3.Security Comparison of Gastroscopy in Each Group3.1 Changes of Oxygen Saturation(Sp02):After treatment,the blood oxygen saturation of group A was significantly lower than that of group B,and the blood oxygen saturation fluctuation in group B was stronger than that in group A and C.3.2 Heart Rate Changes:after dosing,reduction of HR in group B was more obvious than group A and group C.Increase of HR in group C was more obvious than group A and group B.In the entire examination,fluctuation of HR in group A was more stable than group B and group C.3.3 Changes of SBP:Reduction of SBP in group B in examination process was more obvious than group A and group C.Increase of SBP in group C was obvious than group A and group B.3.4 Changes of DBP:the reduction of DBP in group B after dosing was more obvious than group A and group C.Conclusions:1.The pain score,intraoperative matching scores,the satisfaction with the operation and the simility of the quadratic rate of microscopic examination of Dexmedetomidine and Midazolam's conscious sedation anesthesia in the stomachoscopy,are superior to Dyclonlne group anesthesia gastroscope;2.1n the conscious sedation gastroscope,the heart rate of Dexmedetomidine was significantly slower than that of Midazolam but no special treatment was needed:Compared with Dexmedetomidine,there is mild respiratory depression in Midazolam.The oxyhemoglobin saturation pick up quickly by increasing the flow of blood oxygen saturation through nasal catheter.The forgetting degree is higher than that of Dexmedetomidine in the end and in the process of examination,and the quadratic rate of microscopic examination is high.3.On the whole,Midazolam and Dextromidine can make the patients achieve the desired sedation effect,keep them "awake"and reduce their pain in the examination and they have minor effects on respiration and hemodynamics.It is safe and effective to use them in the conscious sedation gastroscope.What's more,the satisfaction of patients is high,the untoward effect is less,the rate of accepting quadratic examination is high,which accord with the requirement of painless gastroscope,contributing to the development and popularization of the technology of painless gastroscope.