目的：研究右美托咪定复合舒芬太尼用于内镜逆行胰胆管造影术（endoscopic retrograde cholangiopan-creatography,ERCP）的麻醉效果,并观察血流动力学和不良反应的发生率。方法：通过麻醉监测管理行ERCP检查和治疗52例病人,随机分为右美托咪定复合舒芬太尼的静脉麻醉组（研究组）和利多卡因喉头喷雾的传统局部麻醉组（对照组）各26例,进行临床对比研究。评估两组的一般情况。分别记录麻醉前、给药（5 min、10 min）、进镜即刻、ERCP操作（1 min、3 min、5 min、10 min、15 min）、退镜结束的平均动脉压、心率和氧饱和度,共11次。观察病人在检查过程中的不良反应,包括呛咳、恶心呕吐、烦躁不安、体动反应和呼吸抑制,并在术后第1天随访,包括病人对检查、治疗过程的体验感受和愿意接受ERCP。结果：与对照组相比,研究组病人血流动力学变化、不良反应发生率显著减低（P<0.05）。两组氧饱和度差异无统计学意义。研究组愿意接受检查率为100%,而对照组为65%。研究组ERCP时间明显缩短（P<0.05）。结论：应用右美托咪定复合舒芬太尼静脉麻醉,实施麻醉监测管理的ERCP检查和治疗,让病人安全和舒适,使病人更愿意接受。

Objective To study the effect of anesthesia with a dexmedetomidine-sufentanil combination in patients undergoing endoscopic retrograde cholangiopancreatography(ERCP), we observe the hemodynamic variation and the incidence of adverse reactions. Methods Fifty-two patients with ERCP were randomized and divided into two groups each 26 cases: study group using anesthesia with a dexmedetomidine-sufentanil combination and control group using local anesthetics with lidocaine aerosol. Clinical results were compared. Characteristic and demography in two groups were evalua-ted. Mean arterial pressure, heart rate and pulse oxygen saturation value were recorded with examination of a total 11 times including before anesthesia, and 5 min, 10 min after intravenous anesthetics, and at the time of entering the endoscopy, and the time of 1 min, 3 min, 5 min, 10 min, 15 min during ERCP, and at the end of ERCP endoscopic operation. The adverse effect during ERCP was observed including cough, nausea and vomiting, dysphoria, restlessness and respiratory depression. The degree of comfort and acceptance of patients were recorded on the first day after ERCP. Results Hemodynamic variation and the incidence of adverse reactions were significantly lower in study group than those in control group respectively(P<0.05). There was no significant difference in pulse oxygen saturation between two groups. The accep-tability to receive ERCP was 100% in study group and 65% only in control group. The operative time was significantly shorter in study group than that in control group(P<0.05). Conclusions Anesthesia with dexmedetomidine-sufentanil combination under monitored care for ERCP could have an advantage of more safe and more comfort on patients and acceptance.