依托咪酯与丙泊酚联合地佐辛用于老年胃镜检查麻醉的临床观察  

Anesthesia by etomidate and propofol combined with dezocine for elderly patients undergoing gastroscopy

作　　者：韩明杰[1] 张凌宇[1] Han Mingjie;Zhang Lingyu(Department of Anesthesiology,First Hospital Affiliated to Xiamen University,Xiamen 361001,China)

机构地区：[1]厦门大学附属第一医院麻醉科,361001

出　　处：《国际医药卫生导报》2021年第13期1980-1984,共5页International Medicine and Health Guidance News

摘　　要：目的观察依托咪酯与丙泊酚联合地佐辛用于老年患者胃镜检查麻醉的临床效果。方法选取2018年10月至12月于厦门大学附属第一医院胃镜中心择期行胃镜检查术的患者150例,随机数字表法分为丙泊酚组(P组)、依托咪酯组(E组)与丙泊酚联合依托咪酯组(PE组),各50例。麻醉诱导,地佐辛5 mg。P组静脉注射丙泊酚1.50~2.00 mg/kg,4.00 mg·kg^(-1)·h^(-1)维持;E组,静脉注射依托咪酯0.150~0.200 mg/kg,0.40 mg·kg^(-1)·h^(-1)维持;PE组,静脉注射丙泊酚0.75~1.00 mg/kg+依托咪酯0.075~0.100 mg/kg,丙泊酚2.00 mg·kg^(-1)·h^(-1)+依托咪酯0.200 mg·kg^(-1)·h^(-1)混合液维持。观察麻醉前(T_(0))、检查前(T_(1))、检查开始后1 min(T_(2))、3 min(T_(3))、5 min(T_(4))、10 min(T_(5))、15 min(T6)时患者的心率(HR)、平均动脉压(MAP)及脉搏血氧饱和度(SPO2),恶心呕吐、咳嗽体动、肌颤、注射痛与呼吸抑制。结果P组T1~T5时刻MAP均明显低于T0时刻[(58.0±5.6)mmHg(1 mmHg=0.133 kPa)、(64.5±6.7)mmHg、(63.1±6.3)mmHg、(62.8±6.1)mmHg、(63.0±6.4)mmHg比(71.5±8.9)mmHg,均P<0.05];E组T_(2)、T_(3)时刻HR、MAP明显高于T0时刻[(79.3±9.1)次/min、(79.2±9.0)次/min比(72.5±9.0)次/min和(80.5±9.5)mmHg、(80.0±9.3)mmHg比(73.8±8.3)mmHg,均P<0.05];P组T1、T2与T3时刻MAP明显低于E组[(58.0±5.6)mmHg比(71.8±8.1)mmHg、(64.5±6.7)mmHg比(80.5±9.5)mmHg和(63.1±6.3)mmHg比(80.0±9.3)mmHg,均P<0.05];P组T_(2)、T_(3)时刻HR明显低于E组[(67.5±7.7)次/min比(79.3±9.1)次/min和(67.8±7.9)次/min比(79.2±9.0)次/min,均P<0.05];P组恶心呕吐、咳嗽体动与肌颤发生率明显低于E组[6%(3/50)比30%(15/50)、10%(5/50)比34%(17/50)、2%(1/50)比32%(16/50),均P<0.05];P组呼吸抑制与注射痛明显高于E组[36%(18/50)比10%(5/50)、24%(12/50)比6%(3/50),均P<0.05];PE组E组恶心呕吐、咳嗽体动与肌颤发生率明显低于[8%(4/50)比30%(15/50)、12%(6/50)比34%(17/50)、10%(5/50)比32%(16/50),均P<0.05],呼吸抑制明显低于P组[12%(6/50)�Objective To observe clinical efficacy of anesthesia by etomidate and propofol combined with dezocine for elderly patients undergoing gastroscopy.Methods One hundred and fifty ASA I or II elderly patients undergoing gastroscopy at the Center of Digestive Endoscopy of First Hospital Affiliated to Xiamen University from October to December,2018 were divided into a propofol group(group P),an etomidate group(group E),and a propofol combined with etomidate group(group PE)by the random number table method,with 50 cases in each group.Five mg dezocine was used for anesthesia induction.Group P were intravenously injected propofol 1.50~2.00 mg/kg,and the anesthesia was maintained at 4.00 mg·kg^(-1)·h^(-1).Group E were intravenously injected etomidate 0.150~0.200 mg/kg,and the anesthesia was maintained at 0.400 mg·kg^(-1)·h^(-1).Group PE were intravenously injected propofol 0.75~1.00 mg/kg and etomidate 0.075~0.100 mg/kg,and the anesthesia was maintained at 2.00 mg·kg^(-1)·h^(-1) and 0.200 mg·kg^(-1)·h^(-1).The heart rates(HR),mean arterial pressures(MAP),and saturations of pulse oximetry(SPO_(2))were recorded before anesthesia induction(T_(0)),before gastroscopy(T_(1)),and 1(T_(2)),3(T_(3)),5(T_(4)),10(T_(5)),and 15 min(T_(6))after gastroscopy,postoperative nausea and vomiting,bucking response,myoclonus,injection pain,and respiratory depression were observed.Results The MAP's in group P at T_(1),T_(2),T_(3),T_(4),and T_(5) were lower than that at T0[(58.0±5.6)mmHg(1 mmHg=0.133 kPa),(64.5±6.7)mmHg,(63.1±6.3)mmHg,(62.8±6.1)mmHg,and(63.0±6.4)mmHg vs.(71.5±8.9)mmHg;all P<0.05].The MAP's and HR's in group E at T2 and T3 were higher than those at T0[(79.3±9.1)beats/min and(79.2±9.0)beats/min vs.(72.5±9.0)beats/min;(80.5±9.5)mmHg and(80.0±9.3)mmHg vs.(73.8±8.3)mmHg;all P<0.05].The MAP's at T1,T2,and T3 in group P were lower than those in group E[(58.0±5.6)mmHg vs.(71.8±8.1)mmHg,(64.5±6.7)mmHg vs.(80.5±9.5)mmHg,and(63.1±6.3)mmHg vs.(80.0±9.3)mmHg;all P<0.05].The HR's at T2 and T3 in group P were lower tha

关 键 词：依托咪酯 丙泊酚 地佐辛 老年患者 胃镜检查 

分 类 号：R614[医药卫生—麻醉学]