Application of small dose dexmedetomidine combined with target-controlled infusion of propofol in painless enteroscopy for patients with obesity

YU Xuan; HE Liang; LI Aiguo

doi:10.3969/j.issn.1002-7386.2018.02.006

Abstract：Objective To investigate the anesthesia effects and safety of small dose dexmedetomidine (Dex) combined with target-controlled infusion (TCI) of propofol at three different preset plasma concentrations in painless enteroscopy for patients with obesity.Methods One hundred and twenty patients who underwent painless enteroscopy in our hospital from May 2015 to August 2016 were randomly divided into trial group (group A,n =60) and control group (group B,n =60).The patients in group A were given Dex 0.5μg/kg by intravenous pumping,within 10 min,however,the patients in group B were given equal volume 0.9％ sodium chloride solution.According to different preset target plasma concentration of propofol,the group A and group B were redivided into group A1 and B1 (2μg/ml),group A2 and B2 (3 μg/ml),group A3 and B3(4μg/ml).The 5 time points were selected in group A and group B including before anaesthesia (T1),10 min after pumping (T2),loss of consciousness (T3),5 min after enteroscopy (T4),end of the operation (T5).Then the BIS,SPO2,MAP,RR were detected,moreover,the additional propofol,cough,respiratory repression,hypotension,hypoxia and incidence rate of complications during the operation were observed.Finally the sedative effects including Ramesay score and leaving hospital score were evaluated and compared between the two groups.Results The BIS,RR,MAP,SPO2 in group A1 at T4,T5 were superior to those in group B 1,A2,A3 (P ＜ 0.05).No complications were found in group A1,however,cough,respiratory repression,hypotension and hypoxia were found in group A2 and group A3.The Remasay scores and leaving hospital scores in group A1 were obviously higher than those in group B1,but leaving hospital scores in group A1 were superior to those in group A2 and group A3 (P ＜ 0.05).Conclusion When obese patients receive painless enteroscopy,pumping beforehand intravenously Dex 0.5 μg/kg combined with target-controlled infusion of propofol of 2μg/ml can obtain satisfactory anaesthesia effects,which can effectively decrease incidence rates of complications and can increase sedative effects.