目的：比较盐酸右美托咪定与异丙酚在无痛结肠镜检查中的麻醉效果和安全性。方法：80 例拟行无痛结肠镜检查患者

随机均分为A组和B组。A组患者30 s 内泵注异丙酚负荷剂量1 mg/kg，后以6 mg/（kg·h）维持；B组患者5 min内微量泵缓慢泵注

盐酸右美托咪定注射液负荷剂量0.3 μg/kg，后以0.2～0.3 μg/（kg·h）维持。观察两组患者检查前（T0），给药后镜检开始前（T1），镜

检开始后1 min（T2）、10 min（T3），退镜完毕后1 min（T4）、5 min（T5）的平均动脉压（MAP）、心率（HR）、血氧饱和度（SpO2）及呼吸频

率（RR），麻醉起效时间、入镜时间、检查时间、离院时间，辅助使用芬太尼患者例数及不良反应发生情况。结果：A组患者T1时的

MAP显著低于同组T0时，两组患者T1～T3时的HR均显著低于同组T0时，差异均有统计学意义（P＜0.05），但两组患者各时点的

SpO2、RR比较，差异均无统计学意义（P＞0.05）。B组患者麻醉起效时间、辅助使用芬太尼患者例数、不良反应发生率均显著低于

A组，差异均有统计学意义（P＜0.05）。结论：盐酸右美托咪定与异丙酚在无痛结肠镜检查中均有较好的麻醉效果，但盐酸右美托

咪定安全性更好。

OBJECTIVE：To compare the anesthetic effect and safety of dexmedetomidine hydrochloride and propofol in painless

colonoscopy. METHODS：80 patients who underwent painless colonoscopy was retrospectively analyzed and divided into group

A and group B. Group A was given loading dose of 1 mg/kg propofol within 30 s and maintained with 6 mg/（kg·h）；group B was

given loading dose of 0.3 μg/kg Dexmedetomidine hydrochloride injection by micropump for slow pumping 5 min and maintained

with 0.2-0.3 μg/（kg·h）. Mean arterial pressure（MAP），heart rate（HR），oxygen saturation（SpO2）and respiratory rate（RR）before

examination（T0），before microscopic examination（T1），1 min（T2）and 10 min（T3）after microscopic examination，1 min

（T4）and 5 min（T5）after colonoscopy withdrawal，onset time of anesthesia，entry time，examination time and discharge time，patients

with adjunctive use of fentanyl and incidence of adverse reactions in 2 groups were observed. RESULTS：MAP in group A at

T1 was significantly lower than T0，HR in 2 groups at T1-T3 was significantly lower than T0，the differences were statistically significant（

P＜0.05），however，there were no significant differences in the SpO2 and RR between 2 groups（P＞0.05）. Onset time of anesthesia，

patients with adjunctive use of fentanyl and incidence of adverse reactions in group B were significantly lower than group

B，the differences were statistically significant（P＜0.05）. CONCLUSIONS：Both dexmedetomidine hydrochloride and propofol has

good anesthetic effect in painless colonoscopy，but dexmedetomidine has better safety.