Dexmedetomidine For Patients With Spontaneous Breathing Endoscopic Ultrasonography Study On Analgesic And Sedative Effects

Objective:The uplift of the esophagus,stomach,etc.need to be diagnosed by endoscopic ultrasonography,the successful completion of microscopy need to implement effective anesthesia.Traditional anesthesia for topical anesthesia,such as lidocaine or tetracaine aerosol spray throat,although this anesthesia can pr otect the airway,but difficult to achieve the desired results.The general anesth esia on respiratory and circulatory inhibition is obvious,for patients with sever e respiratory and circulatory diseases,anesthesia is facing great challenges.In t his paper,the clinical effects of dexmedetomidine on anesthesia in patients wit h painless endoscopic ultrasonography were studied.The sedative effect of the patients was observed and the frugality of the drugs was analyzed.Methods:From January 2015 to January 2016,160 patients with Patients with digestive diseases were admitted to our hospital.All patients underwent painless endoscopic ultrasonography.After informed consent was signed,the patients were randomly divided into observation group and control group.The patients in the observation group were anesthetized with dexmedetomidine,and dexmedetomidine was diluted to 4μg/mL with normal saline.The total amount of the drug was calculated according to 1.0μg/kg,and the microinjection pump was used in ten minutes The dose was induced at a constant rate and 5 mL of 1.5%lidocaine was inhaled by hyperoxia to induce topical anesthesia.In the control group,5 mL of 1.5%lidocaine was inhaled at a speed of 7L/min,and local anesthesia was performed with cricothyroid membrane puncture.Two groups of patients were used to connect the oxygen bottle with high pressure oxygen to 3L/min flow of high concentration oxygen inhalation.The mean arterial pressure（MAP）,heart rate（HR）,and oxygen saturation（SPO₂）of the two groups of patients were recorded before and after anesthesia（T1）,before endoscopic ultrasonography.（T2）（T3）,Insert the lesion immediately（T4）,and at the end of the examination（T5）,the anesthesia and physiologic parameters of the patients were comprehensively monitored.On this basis,the anesthesia The adverse effects of the two groups of patients during the examination were recorded and compared.To summarize the anesthetic and sedative effects of dexmedetomidine on painless endoscopic ultrasonography and the thrift effect on general anesthetics.Statistical analysis of the two groups of patients using SPSS 11.0,measurement data to mean±standard deviation（^<sub>x±s）,compared between groups using t test,compared with the analysis of variance within the group.Count data is expressed as a rate,using the x² test.P<0.05 for the difference was statistically significant.There were no significant differences in sex,age and general condition between the two groups（P>0.05）.The operation time of the two groups was compared and the average operation time of the observation group was（15.35±4.21）min.The average operation time was（20.26±5.46）min in the control group.The results showed that the operation time of the observation group was significantly smaller than that of the control group.（P<0.05）.MAP,HR and SPO2 were compared between the two groups.The mean arterial pressure（MAP）,heart rate（HR）,and oxygen saturation（SPO₂）of the observation group and the control group at the time point were（95.25±2.50）)mmHg、（79.45±8.10）BPM,（98.20±1.44）%,（95.25±8.28）mmHg,（79.54±8.23）BPM and（98.34±1.52）%respectively.There was no significant difference between the two groups,The mean arterial pressure（MAP）and heart rate（HR）of the patients in the control group showed a gradual increase trend,indicating that the patients had severe stress reaction during the operation.The observation group data showed that the heart rate（MAP）were significantly lower than those of the control group（P<0.05）.The mean arterial pressure（MAP）was lower in the two groups than in the control group（P<0.05）（HR）increased from T1（78.55±8.34）BPM to（97.25±10.39）BPM.The mean arterial pressure（MAP）and heart rate（HR）of the patients in the observation group were significantly lower at T2 time point（95.38±2.52）mmHg,（79.31±8.15）BPM to（90.21±8.32）mmHg,（70.14±8.45）BPM,respectively,indicating that the mean arterial blood pressure and heart rate of the patients in the observation group decreased gradually with the drug taking effect（P<0.05）.There was no significant difference in blood oxygen saturation（SPO₂）between observation group and control group at T1 time point（P>0.05）,but there was no significant difference between the two groups（P>0.05）,but the difference was statistically significant（P<0.05）.There was significant difference between the control group and the observation group（P<0.05）.Compare the anesthesia effect of two groups of patients.After the two groups of patients anesthesia,the observation group using dexmedetomidine to induce the implementation of awake anesthesia for the patients before the inspection,the observation group of patients with Ramsay score of more than 4 points,the examination process,patients have a clear consciousness,can be effective And the patients in the control group were kept awake,but the ability of checking was poor.The difference between the two groups was statistically significant（P<0.05）,indicating that the anesthesia effect of the observation group was significantly better than the control group.Comparison of the two groups of patients during the examination of the adverse reaction rateThere were 10 cases of adverse reactions in the observation group,including 3cases of agitation,2 cases of choking,2 cases of arrhythmia,1 case of suffocation,2cases of hemoptysis;the control group 40 There were 15 cases of restlessness,6 cases of choking,3 cases of arrhythmia,3 cases of suffocation,5 cases of hemoptysis,3 cases of bronchospasm,2 cases of epistaxis,3 cases of interruption,indicating that the observation group of patients during the examination of the incidence of adverse reactions was significantly lower than the control group,the difference was statistically significant（P<0.05）.Conclusion:Right anesthesia with dexmedetomidine can achieve good anesthesia effect in the patients who need painless endoscopic ultrasonography,meanwhile the mean arterial pressure（MAP）and heart rate（HR）of the patients are stable during the examination,meanwhile the blood oxygen Saturation（SPO₂）no significant changes in the examination process in patients with a good condition in the body,in addition to the application of dexmedetomidine anesthesia can also improve patient comfort during the inspection process,help patients to actively cooperate with the various Check,to check the successful completion of the examination process is not easy to occur in patients with various adverse reactions,and patients without general anesthesia,can save anesthesia drugs,has good application prospects.