无痛胃肠镜检查中应用依托咪酯-丙泊酚混合液的麻醉效果

 目的 探讨无痛胃肠镜检查中应用依托咪酯复合丙泊酚静脉麻醉的效果。方法 选取2019年2-5月就诊于解放军第三〇五医院符合麻醉评估要求的无痛胃肠镜检查患者240例,采用随机数字表法将入组患者随机分为丙泊酚组(P组)和依托咪酯-丙泊酚组(E-P组),每组120例,P组用丙泊酚静脉麻醉诱导,E-P组用依托咪酯复合丙泊酚静脉麻醉诱导,麻醉维持阶段两组均使用丙泊酚,麻醉期间全程监测各组患者的无创血压(non-invasive blood pressure, NBP)、心率(heart rate, HR)和脉搏血氧饱和度(saturation of pulse oximetry, SPO₂),并记录麻醉诱导时间、胃肠镜检查时间、患者苏醒时间,以及循环抑制、呼吸抑制、注射痛、肌阵挛等不良反应发生的数量。结果 与P组比较,E-P组的患者出现平均血压下降(11.67% vs. 24.17%,P=0.0184)、呼吸抑制(8.33% vs. 22.50%,P=0.0042 )和注射痛(5.83% vs. 50.83%,P<0.0001)的发生率均明显降低,两组间肌阵挛的差异也有统计学意义(P<0.05),但E-P组发生率较高(15.00% vs. 5.83%, P=0.0346)。结论 依托咪酯-丙泊酚混合液静脉麻醉在无痛胃肠镜检查中的应用更加安全、舒适,循环呼吸抑制和注射痛的不良反应明显减少。

Applicability of admixture of etomidate and propofol to painless gastroenteroscopy

Objective To investigate the applicability of intravenous administration of the admixture of etomidate and propofol to painless gastroenteroscopy.Methods Between February and May 2019, 240 patients undergoing painless gastroenteroscopy who met the requirements of anesthesia in our hospital were enrolled. These patients were randomly divided into two groups: propofol group (group P) and admixture of etomidate and propofol group (group E-P), with 120 patients in each. Anesthesia was induced by propofol in group P, but by the admixture of etomidate and propofol in group E-P. However, propofol alone was used in either group during maintenance of anesthesia. Non-invasive blood pressure (NBP), heart rate (HR) and saturation of pulse oximetry (SPO₂) were monitored during anesthesia. All data was recorded, including the time of anesthesia induction, the time of gastroenteroscopy and awakening, as well as the number of such adverse reactions as circulatory inhibition, respiratory depression, injection pain and myoclonus in either group.Results There was significant difference in the incidence of circulatory inhibition, respiratory depression and injection pain (P=0.0184, P=0.0042, P<0.0001, respectively) between the two groups, which was significantly lower in group E-P(11.67% vs. 24.17%, 8.33% vs. 22.50%, 5.83% vs. 50.83%, respectively). The difference in the incidence of myoclonus was statistically significant (P<0.05), which was higher in group E-P(15.00% vs. 5.83%, P=0.0346).Conclusions The admixture of etomidate and propofol used for anesthesia induction in painless gastroenteroscopy can decrease the incidence of adverse reactions including injection pain and inhibition of circulation and respiration so that it can make painless gastroenteroscopy safer and more comfortable.