右美托咪定和丙泊酚在精神分裂症患者 MRI 检查中的效果比较

Comparison of effect of two kinds of anesthetics in MRI examinaiton for patients with schizophrenia

摘要:

目的 评价右美托咪定和丙泊酚用于不合作的精神分裂症患者行MRI 检查时的麻醉效果和不良 反应。方法 选取2015 年12 月-2016 年10 月于新乡医学院第二附属医院门诊和住院需进行MRI 检查的不 合作精神分裂症患者100 例，随机分为右美托咪定组（A 组）和丙泊酚组（B 组），监测给负荷量前后的心率、 血压、呼吸频率及血氧饱和度，观察并记录两组药物起效时间、泵注时间、扫描时间、苏醒时间及出恢复室 时间。结果 两组扫描时间和泵注时间比较无差异（P >0.05）；两药在起效时间、苏醒时间及离开恢复室时 间比较有差异（P <0.05），两组患者用药后心率和血压较用药前下降，B 组T2 时血氧饱和度较T1 降低（P <0.05）； 用药后B 组呼吸频率、血压及血氧饱和度下降程度高于A 组（P <0.05）；B 组有1 例在进入MRI 室前出现 轻微呼吸抑制，经仰额举颌处理后症状消失。两组均未出现其他不良反应。结论 右美托咪定和丙泊酚均可 用于MRI 检查不合作的精神分裂症患者时麻醉镇静，但需严密监测，且丙泊酚可用于需要快速镇静的患者， 右美托咪定在镇静过程中无呼吸抑制，但须注意两药对循环系统的影响。

Abstract:

Objective To evaluate the efficacy and safety of Dexmedetomidine and Propofol in the examination of magnetic resonance imaging (MRI) in the patients with schizophrenia. Methods Totally 100 schizophrenia patients, who had MRI examination in the Second Affiliated Hospital of Xinxiang Medical University from December 2015 to October 2016, were randomly divided into Dexmedetomidine group (group A) and Propofol group (group B). Heart rate, blood pressure, respiration rate and oxygen saturation were monitored before and after injection of loading dosage of the corresponding anesthetic. Drug onset time, awakening time, pump injection time, MRI scan time and time leaving the recovery room were observed and recorded. Results There was no significant difference in the pump injection time or the MRI scan time between the two groups (P > 0.05), while significant differences were observed in the drug onset time, the awakening time and the time leaving the recovery room (P < 0.05). Heart rate and blood pressure of both groups at T2 were significantly lower than those at T1 (P < 0.05). In the group B, the oxygen saturation at T2 was significantly lower than that at T1 (P < 0.05). After medication, the degree of decrease in breathing rate, blood pressure and blood oxygen saturation in the group B was more obvious than that in the group A, the difference was statistically significant (P < 0.05). In the group B, 1 case had respiratory depression before entering the MRI room, and the symptom disappeared after the maxillary jaw treatment. No adverse effects were observed in either group. Conclusions Dexmedetomidine and Propofol are safe and effective for uncooperative schizophrenia patients who need MRI scan. Propofol can be used in the patients requiring rapid sedation, Dexmedetomidine has no breath inhibition role in the sedation process, but for both drugs, we should pay attention to the influence on the circulatory system.