| 刘 超,李 珂,赵海娟,曹 江,郭志福.右美托咪定联合丙泊酚在房颤电复律中的镇静效果研究[J].,2022,(7):1396-1400 |
| 右美托咪定联合丙泊酚在房颤电复律中的镇静效果研究 |
| Sedative Effect and Security of Propofol-Dexmedetomidine in Electrical Cardioversion of Atrial Fibrillation |
| 投稿时间：2021-12-23 修订日期：2022-01-18 |
| DOI：10.13241/j.cnki.pmb.2022.07.042 |
| 中文关键词: 电复律 右美托咪定 丙泊酚 呼吸抑制 |
| 英文关键词: Electrical Cardioversion Dexmedetomidine Propofol Respiratory depression |
| 基金项目:国家自然科学基金项目（81970278） |
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| 中文摘要: |
| 摘要 目的：在接受电复律的房颤患者中，观察比较丙泊酚联合右美托咪定和单用丙泊酚镇静的安全性及有效性。方法：2021年1月至2021年10月期间纳入60例接受电复律的房颤患者，根据随机数表法分为观察组（丙泊酚-右美P-D组）和对照组（丙泊酚 P组），每组30人，观察两组T0-T4不同阶段的生命体征、不良事件、镇痛效果、苏醒时间等指标。结果：P-D组在T1-4时段HR较T0减低，P组T2-4时段HR也较T0下降，但两组间无明显差异。两组在T2、T3时MAP、SpO2均低于T0，但T2时段P-D组MAP、SpO2下降幅度低于P组， T3时段SpO2下降幅度低于P组， MAP降幅无差异。P-D组丙泊酚用量显著低于P组（48.67±15.03 mg vs 71.33±19.03 mg；P<0.001），但苏醒时间无明显差异。P-D组呼吸抑制、心动过缓的发生率均低于P组（16.7% vs 40% P=0.045；13.3% vs 3.3% P=0.35）。P-D组镇痛评分为轻度以下者占93.3%，显著优于P组的73.3%（P<0.05）。结论：对电复律的房颤患者，丙泊酚-右美托咪定复合策略展现出良好的镇静、镇痛效果，该方案可明显降低丙泊酚用量，减少临床不良事件率，增强了用药安全性。 |
| 英文摘要: |
| ABSTRACT Objective: To explore the security and effectiveness of Propofol-Dexmedetomidine and Propofol alone in sedation strategy for atrial fibrillation patients received electrical cardioversion. Methods: From January 2021 to October 2021, atrial fibrillation patients(n=60) received electrical cardioversion were enrolled and randomly divided into observation group (propofol - dexmedetomidine n=30) and control group (propofol n=30). The vital signs, adverse events, analgesic effect, and recovery time at different stages of T0-T4 were observed. Results: In P-D group, HR was lower than T0 in T1-4, the MAP and SpO2 began to decreased in T2-3. In P group, SpO2, HR and MAP in T2-4 were all inferior to baseline period of T0. Whereas, in P-D group, the descend range of MAP and SpO2 of T2, and the SpO2 of T3 were distinctly less than the P group. No obvious diversity was observed in HR and falling range of MAP of T3 period between two groups. The amount of propofol in P-D group signally reduced (48.67±15.03 mg vs 71.33±19.03 mg; P<0.001), nevertheless, there was no remarkable difference in revivification period (P=0.161). The adverse events including respiratory depression and bradycardia in P-D group were inferior to the P group (16.7% vs 40% P=0.045; 13.3% vs 3.3%; P=0.35). The satisfaction of analgesia in P-D group was apparently prominent than P group (93.3% vs 73.3%; P<0.05). Conclusion: The strategy of Propofol - dexmedetomidine could provide prominent sedative and analgesic effectiveness for atrial fibrillation patients received electrical cardioversion, signally reduce the amount of propofol and adverse events, reinforcing the security of medication. |
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