摘要
目的探讨不同剂量艾司氯胺酮复合环泊酚用于无痛胃肠镜检查的有效性和安全性。方法择期行门诊无痛胃肠镜检查的患者240例,年龄18~64岁,体重指数(BMI)18~30 kg/m^(2),美国麻醉医师协会(ASA)分级Ⅰ、Ⅱ级,按随机数字表法分为4组(每组60例):艾司氯胺酮0.2 mg/kg组(E1组)、艾司氯胺酮0.3 mg/kg组(E2组)、艾司氯胺酮0.4 mg/kg组(E3组)、单纯环泊酚麻醉组(C组)。E1组、E2组、E3组分别静脉注射艾司氯胺酮0.2、0.3、0.4 mg/kg,30 s后静脉注射环泊酚0.2~0.4 mg/kg;C组静脉注射环泊酚0.4 mg/kg。记录4组患者改良警觉/镇静评分(mOAA/S)≤1分时间、检查时间、苏醒时间、离院时间。记录4组患者入室时(T_(0))、进胃镜后即刻(T_(1))、出胃镜时(T_(2))、进肠镜后即刻(T_(3))、内镜到达回盲部时(T_(4))、肠镜结束时(T_(5))及清醒时(T_(6))的心率、脉搏血氧饱和度(SpO_(2))、平均动脉压(MAP)、呼吸频率(RR)、脑电双频指数(BIS),记录4组患者术中(呛咳、呼吸抑制、低血压、心动过缓、体动、呃逆)及术后(头晕、恶心呕吐、复视、分泌物增多、噩梦)不良反应的发生情况。记录4组患者环泊酚用量、追加环泊酚例数、使用麻黄碱例数及追加镇痛药例数。结果与C组比较,E1组、E2组、E3组mOAA/S≤1分时间较短(均P<0.05),E3组苏醒时间、离院时间较长(均P<0.05)。与E3组比较,E1组、E2组mOAA/S≤1分时间、苏醒时间、离院时间均较短(均P<0.05)。与C组比较,E1组、E2组、E3组环泊酚用量、使用麻黄碱例数、追加镇痛药例数较少(均P<0.05),E2组追加环泊酚例数较少(P<0.05),E2组、E3组术中呛咳、低血压发生率较低(均P<0.05);与E1组比较,E2组术中呛咳发生率较低,E2组、E3组术中低血压发生率较低(均P<0.05);与E2组比较,E3组术中呛咳发生率较高(P<0.05)。E3组术后头晕、分泌物增多、复视发生率高于E1组、E2组、C组(均P<0.05)。与T_(0)时比较:4组患者T_(4)~T
ObjectiveTo investigate the efficacy and safety of different doses of esketamine combined with ciprofol in patients undergoing painless gastrointestinal endoscopy.MethodsA total of 240 patients,aged 18-64 years,body mass index(BMI)of 18-30 kg/m^(2),American Society of Anesthesiologists(ASA)gradeⅠorⅡ,were selected for outpatient painless gastrointestinal endoscopy.Patients were divided into 4 groups according to random number table method(60 cases per group):esketamine 0.2 mg/kg group(group E1),esketamine 0.3 mg/kg group(group E2),esketamine 0.4 mg/kg group(group E3)and ciprofol single anesthesia group(group C).The groups E1,E2 and E3 were given intravenous in jection of 0.2,0.3 mg/kg and 0.4 mg/kg esketamine,and ciprofol was given 0.2-0.4 mg/kg after 30 s respectively,group C was given 0.4 mg/kg ciprofol intravenously.The mOAA/S≤1 min,examination time,recovery time and discharge time of 4 groups were recorded.The heart rate,pulse oxygen saturation(SpO_(2)),mean arterial pressure(MAP),respiratory rate(RR),bispectral index(BIS)values were recorded when the patients entered the room(T_(0)),immediately after entering the gastroscopy(T_(1)),immediately after gastroscopy(T_(2)),immediately after entering the endoscopy(T_(3)),when the endoscope reached the ileocecal part(T_(4)),at the end of the endoscopy(T_(5))and when awake(T_(6)).The occurrence of adverse reactions during operation(choking,respiratory depression,hypotension,bradycardia,movement,hiccup)and after operation(giddy,nausea and vomiting,diplopia,increased secretion,nightmares)were recorded in 4 groups.The dosage of ciprofol,the number of additional cases of ciprofol,the number of additional cases of ephedrine and the supplementary analgesic drugs were recorded in 4 groups.ResultsCompared with group C,the time of mOAA/S≤1 min in groups E1,E2 and E3 was shorter(all P<0.05),and the time of recovery and discharge from hospital in group E3 was longer(all P<0.05).Compared with group E3,mOAA/S≤1 min,recovery time and discharge time of groups E1 and E2 we
作者
连一闻
马艳辉
刘淼
吴洁
王天龙
Lian Yiwen;Ma Yanhui;Liu Miao;Wu Jie;Wang Tianlong(Department of Surgical Anesthesiology,Xuanwu Hospital,Capital Medical University,Beijing 100053,China)
出处
《国际麻醉学与复苏杂志》
CAS
2024年第7期696-701,共6页
International Journal of Anesthesiology and Resuscitation
关键词
艾司氯胺酮
环泊酚
无痛胃肠镜检查
有效性
安全性
Esketamine
Ciprofol
Painless gastrointestinal endoscopy
Effectiveness
Security
