依托咪酯复合丙泊酚在老年人无痛胃肠镜检查中的应用效果  

Anesthetic effects of Etomidate emulsion combined with Propofol in elderly patients undergoing painfrce gastrointestinal endoscopy

作　　者：王芳[1] 靳丽敏[1] 汪茜雅[1] 周永芳[1] Wang Fang;Jin Limin;Wang Xiya;Zhou Yongfang(Digestive Endoscopy Center,the First Affiliated Hospital of Soochovu University,Suzhou 215006,China)

机构地区：[1]苏州大学附属第一医院消化内镜中心,215006

出　　处：《中华老年医学杂志》2020年第12期1439-1442,共4页Chinese Journal of Geriatrics

摘　　要：目的探讨在老年人无痛胃肠镜检查中应用依托咪酯复合丙泊酚的麻醉效果及其安全性。方法选取2018年3月至2020年6月在苏州大学附属第一医院行无痛胃肠镜检查的老年人400例,按照入院序号奇偶性将其分为观察组200例(奇数序号,依托咪酯乳剂复合丙泊酚和舒芬太尼)和对照组200例(偶数序号,舒芬太尼复合丙泊酚),对两组受检者麻醉不同时间点的生命体征指标进行监测记录,以对麻醉效果进行评估,并对其不良反应发生情况进行统计。结果两组患者的麻醉起效时间、手术时间差异均无统计学意义(均P>0.05);观察组患者在T1时刻、T2时刻心率[(65.84±6.91)次/min、(65.29±5.42)次/min],收缩压[(129.76±8.33)mmHg(1 mmHg=0.133 kPa)、(126.27±6.12)mmHg],脉搏氧饱和度[(96.39±2.04)%、(96.99±1.64)%],均明显高于对照组[(58.75±7.25)次/min、(56.85±6.79)次/min,(109.25±9.15)mmHg、(99.04±8.26)mmHg,(93.11±1.76)%、(92.28±1.35)%],差异具有统计学意义(t=10.011.13.739、23.441、37.460.17.216、31.358,均P=0.000);观察组患者注射痛的发生率(3.5%,7/200)明显低于对照组(37.5%,75/200),差异具有统计学意义(χ^2=62.830,P=0.000)。结论在老年人无痛胃镜检查中采用依托咪酯复合丙泊酚方案实施麻醉,可在保证麻醉效果的同时维持机体生命体征的稳定性,有利于减轻患者不适感,提高其检查耐受性,对于保证胃镜检查操作的顺利进行具有十分积极的作用。Objective To explore the anesthetic efficacy and safety of Etomidate emulsion combined with Propofol in the elderly undergoing painless gastrointestinal endoscopy.Methods A total of 400 elderly patients undergone painfree gastrointestinal endoscopy in our hospital from March 2018 to June 2020 were enrolled.According to their admission serial numbers,patients were divided into the observation group(patients with odd serial numbers,receiving Etomidate emulsion combined with Propofol and sufentanil)and the control group(patients with even serial numbers,receiving Sufentanil combined with Propofol).Subjects’vital signs at different time points of anesthesia were monitored and recorded to evaluate the anesthetic effects.The incidences of adverse reactions were analyzed.Results There was no significant difference in anesthesia onset time and operation time between the two groups(both P>0.05).The heart rate,systolic blood pressure and pulse oxygen saturation at Ti and T2 time points were higher in the observation group than in the control group(T1:65.84±6.91 times/min vs.58.75±7.25 times/min,129.76±8.33 mmHg vs.109.25±9.15 mmHg,96.39±2.04%vs.93.11±1.76,t=10.011,23.441 and 17.216,all P=0.000;T2:65.29±5.42 times/min vs.56.85±6.79 times/min,126.27±6.12 mmHg vs.99.04±8.26 mmHg,96.99±1.64%vs.92.28±1.35%,t=13.739,37.460 and 31.358,all P=0.000).The incidence of injection pain was lower in the observation group than in the control group(3.5%or 7/200 vs.37.5%or 75/200.χ^2=62.830,P=0.000).Conclusions Etomidate combined with Propofol offers satisfactory anesthesia while stabilizing vital signs in the elderly undergoing painfree gastroscopy,helps to alleviate patient discomfort and promote tolerance,and thus plays a very positive role in ensuring smooth gastroscopy.

关 键 词：胃镜检查 依托咪酯 二异丙酚 麻醉 

分 类 号：R614[医药卫生—麻醉学]