摘要
目的 比较低剂量和高剂量艾司氯胺酮复合丙泊酚在无痛胃镜检查中的麻醉效果。方法 选择2020年1月-2022年10月在本院行无痛胃镜检查的132例患者作为研究对象,按照数字表法随机分为2组,每组均有66例。低剂量组采用低剂量(0.25mg/kg)艾司氯胺酮复合丙泊酚麻醉,高剂量组(0.5mg/kg)采用高剂量艾司氯胺酮复合丙泊酚麻醉。比较两组患者在麻醉诱导前(T0)、麻醉诱导后即刻(T1)、胃镜置入时(T2)、撤出胃镜时(T3)和苏醒时(T4)等不同时间点的MAP、HR、SpO2生命体征相关指标改变;比较两组患者丙泊酚用量、麻醉诱导时间、胃镜检查时间及麻醉后苏醒时间等临床指标;比较两组患者不良反应(体动呛咳、恶心呕吐、精神症状、视觉障碍、分泌物增加、呼吸抑制)的发生率。结果 高剂量组患者T1、T2、T3、T4时的MAP均明显高于低剂量组(P<0.05),而T2、T3时的HR均明显高于低剂量组(P<0.05);低剂量组患者丙泊酚用量明显多于高剂量组(P<0.05),麻醉诱导时间和胃镜检查时间明显长于高剂量组(P<0.05),而麻醉后苏醒时间明显快于高剂量组(P<0.05);低剂量组患者不良反应发生率明显低于高剂量组(P<0.05)。结论 低剂量(0.25mg/kg)艾司氯胺酮复合丙泊酚对患者的生命体征指标影响较小,且不良反应发生率较低,麻醉后苏醒时间较快,更适宜用于无痛胃镜检查。
Objective To compare anesthetic effect of low-dose and high-dose ketamine combined with propofol in painless gastroscopy.Methods The paper chose 132 patients with painless gastroscopy in our hospital from January 2020 to October 2022 as study subjects,and divided them into two groups randomly according to number table method,with 66 cases in each group.Low-dose group(0.25 mg/kg Ketamine)was anesthetized with low-dose ketamine combined with propofol,and high-dose group(0.5 mg/kg Ketamine)with high-dose ketamine combined with propofol.Changes in MAP,HR,and SpO2 vital sign related indicators were compared between two groups at different time points before anesthesia induction(T0),immediately after anesthesia induction(T1),at gastroscopy insertion(T2),at withdrawal of gastroscopy(T3),and at awakening(T4).Clinical indicators including propofol dosage,anesthesia induction time,gastroscopy time,and post anesthesia recovery time were compared between two groups,incidence of adverse reactions(body movement coughing,nausea and vomiting,mental symptoms,visual impairment,increased secretion,respiratory depression)was compared between two groups.Results MAP levels at T1,T2,T3,and T4 in high-dose group were significantly higher than low-dose group(P<0.05),while HR levels at T2 and T3 were significantly higher than low-dose group(P<0.05).Dosage of propofol in low-dose group was significantly higher than high-dose group(P<0.05),anesthesia induction time and gastroscopy examination time was significantly longer than high-dose group(P<0.05).Recovery time after anesthesia was significantly faster than high-dose group(P<0.05).Incidence of adverse reactions in low-dose group(12.12%)was significantly lower than high-dose group(30.30%)(P<0.05).Conclusion Low dose(0.25 mg/kg)of ketamine combined with propofol can achieve little effect on vital signs of patients,with low incidence of adverse reactions,fast recovery time after anesthesia,which is more suitable for painless gastroscopy.
作者
吕旭君
LV Xujun(Anesthesiology Department,Renhuai City Traditional Chinese Medicine Hospital,Renhuai,Guizhou 564500)
出处
《智慧健康》
2023年第21期94-97,共4页
Smart Healthcare
关键词
艾司氯胺酮
丙泊酚
无痛胃镜
麻醉效果
Espex ketamine
Propofol
Painless gastroscopy
Anesthetic effect
