羟考酮复合丙泊酚在无痛超声胃镜检查中的应用

目的：探析超声胃镜检查中应用羟考酮复合丙泊酚镇痛的效果及安全性。方法：前瞻性选取2020年12月-2021年3月期间门诊行超声胃镜检查的60例患者为研究对象,采用随机数字表法将其分为对照组和研究组,每组30例,对照组镇痛方案选择舒芬太尼复合丙泊酚麻,研究组镇痛方案选择羟考酮复合丙泊酚,对比两组患者T₀(麻醉前)、T₁(麻醉后)、T₂(入镜时)、T₃(入镜后3min)、、T₄(退镜时)各项生命指标(HR、SBP、DBP、SpO₂)变化情况、丙泊酚剂量、检查时间、定向力恢复时间、塑形时间以及不良反应发生情况。结果：两组患者T₁、T₂、T₃时HR、SBP、DBP水平较T₀时明显降低(P＜0.05),T₄时恢复至T₀水平(P＞0.05),两组患者各时刻HR、SBP、DBP水平基本相当(P＞0.05);对照组患者T₁、T₂时SpO₂水平较T₀时明显降低(P＜0.05),T₃、T₄时恢复至T₀水平(P＞0.05),研究组T_0-4时SpO₂水平无明显波动(P＞0.05),T₁、T₂时SpO₂水平明显高于对照组(P＜0.05);两组患者在丙泊酚剂量、超声胃镜检查时间基本相当(P＞0.05),研究组患者定向力恢复、苏醒时间明显短于对照组(P＜0.05);研究组患者呼吸抑制、恶心/呕吐发生率为10.00%、13.33%明显低于对照组33.33%、40.00%的对照组患者(P＜0.05);低血压、心动过速、体动等其他不良反应发生率基本相当(P＞0.05)。结论：超声胃镜检查镇痛方案选择羟考酮复合丙泊酚较舒芬太尼复合丙泊酚在稳定患者生命体征、降低不良反应率更具优势,且缩短患者定向力恢复时间及苏醒时间,临床应用效果及安全性更高,可在今后临床应用中广泛推广。

Application of oxycodone combined with propofol in painless ultrasound gastroscopy

Objective: To explore the analgesic effect and safety of oxycodone combined with propofol in ultrasonic gastroscopy. Methods: Sixty patients who underwent ultrasonic gastroscopy in the outpatient department from December 2020 to March 2021 were prospectively selected as the study subjects.They were divided into control group and study group by random number table method, 30 cases in each group.The analgesic program of the control group was sufentanil combined with propofol, and the analgesic program of the research group was oxycodone combined with propofol. T₀ (before anesthesia), T₁ (after anesthesia), T₂ (at endoscopy), T₃ (3min after endoscopy), T₄ (at endoscopy withdrawal) changes of various life indicators (HR, SBP, DBP, SpO₂), propofol dose, examination time, recovery time of directional force, recovery time and occurrence of adverse reactions were compared between the two groups. RESULTS: The levels of HR, SBP and DBP at T₁, T₂ and T₃ were significantly lower than those at T₀ (P < 0.05), and recovered to T₀ at T₄ (P > 0.05). The levels of HR, SBP and DBP at each time in 2 groups were basically similar (P > 0.05). The level of SpO₂ at T₁ and T₂ in control group was significantly lower than that at T₀ (P < 0.05), and recovered to T₀ at T₃ and T₄ (P > 0.05). There was no significant fluctuation of SpO₂ at T_0-4 in research group (P > 0.05), and the level of SpO₂ at T₁ and T₂ was significantly higher than that in control group (P < 0.05). The dosage of propofol and the time of ultrasonic gastroscopy were basically the same between the two groups (P > 0.05), and the time of orientation recovery and awakening in the study group was significantly shorter than that in the control group (P < 0.05). The incidence of respiratory depression and nausea/vomiting in study group was 10.00% and 13.33%, which were significantly lower than 33.33% and 40.00% in control group (P < 0.05). The incidence of hypotension, tachycardia, body movement and other adverse reactions was similar (P > 0.05). CONCLUSIONS: Compared with sufentanil combined with propofol, oxycodone combined with propofol has more advantages in stabilizing patients" vital signs, reducing the rate of adverse reactions, shortening the recovery time of directional force and recovery time of patients, and has higher clinical application effect and safety, which can be widely promoted in the future clinical application.