依托咪酯联合丙泊酚镇静应用于超重患者无痛胃镜检查的效果观察

[目的]比较超重患者无痛胃镜检查中依托咪酯联合丙泊酚与单独使用丙泊酚的效果。[方法]将60例患者随机分为丙泊酚组(P组)和依托咪酯联合丙泊酚组(EP组)。P组在胃镜检查前首次给予1%丙泊酚(1 mg/kg),EP组给予1%丙泊酚(0.5 mg/kg)加依托咪酯(0.1 mg/kg)。后重复给予P组10~20 mg丙泊酚或EP组5~10 mg丙泊酚加1~2 mg依托咪酯,以维持足够的镇静水平。[结果]与T0比较,T1及T2时刻2组患者的收缩压、舒张压、平均动脉压、心率均明显降低,且与EP组相比,P组下降更为显著,差异有统计学意义(P<0.05),EP组麻醉后循环波动较小。与P组相比,EP组患者从静脉注入麻醉药物到患者意识消失的时间更长(P<0.05)。EP组低血压、呼吸抑制以及注射痛的发生例数低于P组,差异有统计学意义(均P<0.05)。[结论]依托咪酯联合丙泊酚对超重患者无痛胃镜检查中的呼吸和循环影响不大,患者苏醒质量高,不良反应少,比单用丙泊酚更安全有效。

Effect of etomidate combined with propofol sedation on painless gastroscopy in overweight patients

[Objevtives]The use of propofol alone during painless gastroscopy has many side effects.Etomidate has advantages in circulation and respiration compared to propofol.In view of the changes in the physiological structure of overweight patients,how the advantages of etomidate are reflected.To this end,we compared the effects of etomidate combined with propofol with propofol alone in painless gastroscopy of overweight patients.[Methods]Sixty patients were randomized into propofol group(P group)and etomidate plus propofol group(EP group).Group P was given 1%propofol 1 mg/kg for the first time before gastroscopy,and 1%propofol 0.5 mg/kg plus etomidate 0.1 mg/kg for the EP group.Repeat group P with 10-20 mg propofol or group EP with 5-10 mg propofol plus 1-2 mg etomidate to maintain adequate sedation levels.[Results]Compared with T0,systolic pressure(SBP),diastolic pressure(DBP),mean arterial pressure(MAP),and heart rate(HR)were significantly lower in the two groups at T1 and T2,and the decrease was more significant in the P group than in the EP group(P<0.05),the EP group had less fluctuations in circulation after anesthesia.Compared with the P group,the EP group had a longer time from intravenous injection of anesthetic to the disappearance of patient consciousness(P<0.05).The incidence of hypotension,respiratory depression,and the injection pain in the EP group was significantly lower than those in the P group.[Conclusion]Etomidate combined with propofol has little effect on the breathing and circulation in patients with overweight without painful gastroscopy.The quality of recovery is high and the adverse reactions are less,which is safer and more effective than propofol alone.