摘要
目的:观察艾司氯胺酮联合苯磺酸瑞马唑仑麻醉对内镜下逆行胰胆管造影术(ERCP)高龄患者循环及呼吸的影响。方法:选取2020年6月至2022年6月于该院行ERCP的93例高龄患者进行前瞻性研究,按随机数字表法将其分为对照组46例和研究组47例。对照组在苯磺酸瑞马唑仑联合右美托咪定麻醉下行ERCP,研究组在艾司氯胺酮联合苯磺酸瑞马唑仑麻醉下行ERCP。比较两组围术期[麻醉诱导前(T_(0))、麻醉诱导1 min(T_(1))、内镜进入咽喉部即刻(T_(2))、切开括约肌时(T_(3))、术毕5 min(T_(4))]循环指标[平均动脉压(MAP)、心率、血氧饱和度(SpO_(2))]水平、呼吸指标(呼吸频率和呼吸指数)水平、麻醉起效时间、麻醉苏醒时间、麻醉相关不良反应发生率。结果:T_(0)、T_(1)时,两组MAP、心率和SpO_(2)水平比较,差异均无统计学意义(P>0.05);T_(2)、T_(3)、T_(4)时,两组MAP、心率水平均低于T_(0)时,差异有统计学意义(P<0.05);T_(2)、T_(3)、T_(4)时,研究组MAP、心率和SpO_(2)水平均高于对照组,差异有统计学意义(P<0.05);T_(0)时,两组呼吸频率、呼吸指数比较,差异均无统计学意义(P>0.05);T_(1)、T_(2)、T_(3)、T_(4)时,两组呼吸频率均低于T_(0)时,但研究组高于对照组,两组呼吸指数均高于T_(0)时,但研究组低于对照组,差异有统计学意义(P<0.05);两组麻醉起效时间比较,差异无统计学意义(P>0.05);研究组麻醉苏醒时间短于对照组,差异有统计学意义(P<0.05);两组麻醉相关不良反应发生率比较,差异无统计学意义(P>0.05)。结论:艾司氯胺酮联合苯磺酸瑞马唑仑麻醉应用于ERCP高龄患者可维持术中循环与呼吸指标水平稳定,效果优于苯磺酸瑞马唑仑联合右美托咪定麻醉。
Objective:To observe effects of Esketamine combined with Remimazolam besylate on circulation and respiration in elderly patients undergoing endoscopic retrograde cholangiopancreatography(ERCP).Methods:A prospective study was conducted on 93 elderly patients who underwent ERCP in the hospital from June 2020 to June 2022.According to the random number table method,they were divided into control group(46 cases)and study group(47 cases).The control group underwent ERCP under the anesthesia of Remimazolam besylate combined with Dexmedetomidine,while the study group underwent ERCP under the anesthesia of Esketamine combined with Remimazolam besylate.The levels of circulatory indexes[mean arterial pressure(MAP),heart rate,blood oxygen saturation(SpO_(2))]and respiratory indexes(respiratory rate and respiratory index),the anesthesia onset time,the anesthesia recovery time,and the incidence of anesthesia-related adverse reactions were compared between the two groups during the perioperative period[before anesthesia induction(T_(0)),1 min after anesthesia induction(T_(1)),immediately after endoscopy entering the throat(T_(2)),incision of the sphincter(T_(3)),5 min after the surgery(T_(4))].Results:At T_(0)and T_(1),there were no statistically significant differences in MAP,heart rate,and SpO_(2)levels between the two groups(P>0.05).At T_(2),T_(3),and T_(4),the levels of MAP and heart rate in the two groups were lower than those at T_(0),and the differences were statistically significant(P<0.05).At T_(2),T_(3),and T_(4),the levels of MAP,heart rate,and SpO_(2)in the study group were higher than those in the control group,and the differences were statistically significant(P<0.05).At T_(0),there were no statistically significant differences in respiratory rate and respiratory index levels between the two groups(P>0.05).At T_(1),T_(2),T_(3),and T_(4),the respiratory rate levels in both groups were lower than those at T_(0),but those in the study group were higher than those in the control group;the respiratory index levels of
作者
齐新风
QI Xinfeng(Department of Anesthesiology of Nanyang Second General Hospital,Nanyang 473000 Henan,China)
出处
《中国民康医学》
2023年第19期68-70,74,共4页
Medical Journal of Chinese People’s Health
关键词
内镜下逆行胰胆管造影术
高龄
艾司氯胺酮
苯磺酸瑞马唑仑
右美托咪定
循环
呼吸
Endoscopic retrograde cholangiopancreatography
Elderly
Esketamine
Remimazolam besylate
Dexmedetomidine
Circulation
Respiration
