Clinical Study Of Propofol Induced Dexmedetomidine Combinded With Sufentanil For Painless Colonoscopy

To compare anesthesia induced by propofol and maintained by dexmedetomidine with induction and maintenance of anesthesia with propofol alone or induction and maintenance of anesthesia with dexmedetomidine alone in the diagnosis and treatment of painless colonoscopy,and to explore the safety and feasibility.All the method are based on analgesia provided by sufentanil.Methods90 patients who were treated by painless colonoscopy in Affiliated Hospital of Tai'an Medical College were randomly divided into three groups,30 in each group.All the three groups were treated with sufentanil provides analgesia,Patients in group I received propofol induction and dexmedetomidine maintained anesthesia;group II received propofol induction propofol maintained anesthesia;group III received dexmedetomidine induced dexmedetomidine maintained anesthesia.The patient's blood pressure,heart rate,SpO2,and respiratory rate were monitored before anesthesia.Give the prescribed medication according to the group until the eyelash reflex has disappeared.Records of patients at begining(T0),5 minutes after drug induction(T1),10 minutes(T2),15 minutes(T3),20 minutes(T4),after discontinuation of 5 minutes(T5)SBP,DBP,HR,SP02,RR and the performance score of T1 to T5(Anesthesia can not wake up is recorded as 1 points,be able to open your eyes after calling,but unable to complete the instruction is recorded as 2 points,be able to complete the doctor's instructions is recorded as 3 points.).The effect of anesthesia was evaluated according to three grades: good,middle and poor.Good : the patient is comfortable without pain;Middle: the patient has mild pain and does not interfere with the examination;Poor: the patient's apparent pain affected the examination.The scores were 1,2 and 3 respectively.The adverse reaction of intraoperative and postoperative are recorded including the change of blood pressure,bradycardia or tachycardia,low oxygen saturation,nausea and vomiting,etc.The above indexes were analyzed statistically.ResultThere was no significant difference in sex,age,weight,SBP,DBP,HR and SpO2 between the three groups(P>0.05),and there were differences between the RR groups(P<0.05);Analgesic effect: there was no difference between the three groups(P>0.05);Bradycardia: Compared with group II,group III bradycardia(HR<50 / min)of the cases were more than that in group II(P<0.05).There was no significant differ-ence between group I and group II,group I and group III(P>0.05);Nausea and vomiting: there was no difference between the three groups(P>0.05);Changes in systolic blood pressure: Intra group comparison: The T1 phase in the three groups was lower than that in the T0 phase(P<0.05),with varying degrees of fluctuation between T1 and T2 phase,T3 phase and T4 phase of the three group showed no significant difference(P>0.05);comparison between groups: The differ-ence of phase T0 and T1 between group I and group II had no significant differ-ence(P>0.05).The difference of phase T0 and T1 in group I and group II was greater than that in group III(P<0.05).Changes in diastolic blood pressure: Intra group comparison: The T1 phase in the three groups was lower than that in the T0 phase(P<0.05),The T1 phase of the three groups fluctuated with T2,T3 and T4 phases in different degrees,there was no signi-ficant difference(P>0.05).The difference between phase T0 and phase T1 in group I and group II has no significant difference(P>0.05).The difference of phase T0 and T1 in group I and group II was greater than that in group III(P<0.05).The change of heart rate: Intra group comparison: group I and group III T1 period decreased than T0 period(P<0.05),group II had stage T1 than in stage T0 had no significant difference(P>0.05),with varying degrees of fluctuation between T1 and T2 phase,T3 phase and T4 phase of the three group were not significantly different(P>0.05);comparison between groups: The difference of T0 phase and T1 phase between group I and group III was greater than that of group II.The difference of phase T0 and T1 in group I and group III has no significant difference(P>0.05).Respiratory rate: the T1 phase in all the three groups was lower than that in the T0 phase(P<0.05);Performance score: There was no significant difference between T1 in group I and it in group II(P>0.05),there was no significant difference between T4 in group I and it in group III(P>0.05).ConclusionOn the basis of sufentanil analgesia,propofol was used to induce anesthesia and dexmedetomidine was used to maintain anesthesia for painless colonoscopy combined the rapid onset of propofol with the anesthetic benefits of arousal during surgery of dexmedetomidine have little effect on blood pressure or respiration,had a high wake-up rate of ten minutes after anaesthesia,be able to coordinate and turn over,the satis-faction of the operator is high,less adverse reactions.It can be used in clinic.