丙泊酚靶控输注联合依托咪酯在无痛胃肠镜检查中的应用  

Application of propofol target-controlled infusion combined with etomidate in painless gastrointestinal endoscopy

作　　者：罗慧榕 陈晓辉[2] 郑晓春[2] Luo Huirong;Chen Xiaohui;Zheng Xiaochun(Department of Anesthesiology,Fujian Medical University Union Hospital,Fuzhou 350001,China;Department of Anesthesiology,Fujian Provincial Hospital,Fuzhou 350001,China)

机构地区：[1]福建医科大学附属协和医院麻醉科,福州350001 [2]福建省立医院麻醉科,福州350001

出　　处：《创伤与急诊电子杂志》2021年第1期19-24,共6页Journal of Trauma and Emergency(Electronic Version)

摘　　要：目的探讨丙泊酚靶控输注(target-controlled infusion,TCI)联合依托咪酯应用于无痛胃肠镜检查的临床效果和安全性。方法选择2018年8月至2019年8月期间于福建省立医院接受无痛胃肠镜检查的患者300例,随机分成丙泊酚组(P组)、丙泊酚复合0.1mg/kg依托咪酯组(0.1EP组)和丙泊酚复合0.15mg/kg依托咪酯组(0.15EP组),每组100例。设置TCI泵起始靶浓度3μg/ml,0.1EP组和0.15EP组分别使用0.1mg/kg、0.15mg/kg依托咪酯缓慢静脉注射,注射完毕后予丙泊酚TCI。记录3组患者麻醉前、入睡后、胃镜检查结束、肠镜检查结束及麻醉苏醒各时间点生命体征、诱导时间、诱导使用丙泊酚剂量、检查使用丙泊酚总量、苏醒时间,检查过程中出现的不良反应:低血压、呼吸抑制、心动过缓、注射痛发生率、术后恶心、呕吐,以及患者、内镜检查医师、麻醉医师三方满意度。结果 0.15EP组患者在麻醉后至恢复时各时间点平均血压(mean blood pressure,MBP)均显著高于其他两组,差异具有统计学意义(P<0.05)。0.15EP组低血压、呼吸抑制、注射痛发生率均低于其他两组,差异具有统计学意义(P<0.05)。0.15EP组及0.1EP组诱导时间较P组短,差异有统计学意义(P<0.05)。0.15EP组诱导使用丙泊酚量及检查使用丙泊酚总量较其余两组少,差异有统计学意义(P<0.05)。0.15EP组患者、内镜检查医师及麻醉医师三方满意度方面均高于其余两组,差异具有统计学意义(P<0.05)。结论丙泊酚TCI联合0.15mg/kg依托咪酯用于无痛胃肠镜检查对患者循环及呼吸影响相对较小,不良反应发生率低,适合在无痛胃肠镜检查中推广应用。Objective To investigate the efficacy and safety of propofol by targetcontrolled infusion(TCI)combined with etomidate in painless gastrointestinal endoscopy.Methods A total of 300 patients from our hospital were randomly divided into the group P,group 0.1EP and group 0.15EP.Patients in group P received propofol TCI alone,and the initial effect site concentration of propofol TCI system was set at 3.0μg/ml.Patients in group 0.1EP and group 0.15EP received intravenous etomidate at 0.1mg/kg or 0.15mg/kg respectively before propofol TCI.The changes of vital signs before and during operation,recovery time,induction dose of propofol,total dosage of propofol,satisfaction of anesthesiologist,surgeon and patients,and the side effects were compared among the three groups.Results Patients of group 0.15EP had higher mean blood pressure(MBP)than other groups(P<0.05).The incidence of hypotension,respiratory depression,and injection pain in the 0.15EP group were lower than those of other groups(P<0.05).The induction time of 0.15EP and 0.1EP groups were shorter than group P(P<0.05).Induction dose of propofol and total dosage of propofol in the group 0.15EP were less than other groups(P<0.05).In the group 0.15EP,the satisfaction of patients,endoscopists and anesthesiologists were higher than other groups(P<0.05).Conclusion Propofol TCI combined with 0.15mg/kg etomidate for painless gastrointestinal endoscopy has less negative impact on hemodynamics and respiratory system,as well as lower incidence of adverse reactions.It is more suitable for painless gastrointestinal endoscopy.

关 键 词：丙泊酚 依托咪酯 靶控输注 无痛胃肠镜 不良反应 

分 类 号：R614[医药卫生—麻醉学]