艾司氯胺酮联合丙泊酚在无痛膀胱镜检查中的应用  

Application of esketamine combined with propofol in Cystoscopy

作　　者：向导 马传根 侯婷婷 于沙双 信文启 李爱香 张义轩 XIANG Dao;MA Chuangen;HOU Tingting;YU Shashuang;XIN Wenqi;LI Aixiang;ZHANG Yixuan(Department of Anesthesiology,Huaihe Hospital of Henan University,Kaifeng 475000,China)

机构地区：[1]河南大学淮河医院麻醉科,河南开封475000

出　　处：《河南大学学报（医学版）》2021年第6期415-418,共4页Journal of Henan University:Medical Science

基　　金：河南省医学科技攻关计划(201404029);开封市科技攻关计划(2003017)。

摘　　要：〔目的〕观察艾司氯胺酮联合丙泊酚在无痛膀胱镜检查中的麻醉效果。〔方法〕选取行无痛膀胱镜检查男性患者100例,年龄22~65岁,体重53~79 kg,ASAⅠ~Ⅱ级,随机数字表法分为:丙泊酚联合舒芬太尼组(PS组)和丙泊酚联合艾司氯胺酮组(PK组),每组50例。PS组缓慢推注舒芬太尼0.1μg/kg;PK组缓慢推注艾司氯胺酮0.15 mg/kg。后给予丙泊酚1~2 mg/kg,记录两组患者各时间点心率、平均动脉压、脉搏血氧饱和度,观察检查过程中体动反应,并记录丙泊酚用量、镜检时间、苏醒时间,以及丙泊酚注射痛、呛咳、呼吸抑制(SpO_(2)<90%)、低血压和恶心呕吐发生情况。〔结果〕各时间点两组患者间心率、平均动脉压、脉搏氧饱和度在各时间点差异无统计学意义(P>0.05);两组间患者间丙泊酚用量、苏醒时间相比,差异无统计学意义(P>0.05);两组间恶心呕吐、体动及注射痛发生率相比,差异无统计学意义(P>0.05);与PK组相比,PS组呛咳、呼吸抑制及低血压发生率明显升高,差异有统计学意义(P<0.05)。〔结论〕艾司氯胺酮联合丙泊酚能够达到无痛膀胱镜检查的镇静镇痛效果,呼吸抑制、呛咳及低血压等不良反应少,值得临床推广。[Objective]To observe the anesthetic effect of esmketamine combined with propofol in painless cystoscopy.[Methods]100 patients,aged 22〜65 years,weight 53〜79 kg,ASA physical status Ⅰ or Ⅱ,who underwent selective painless cystoscopy were randomized into 2 groups,50 patients in each group.In group PS,Sufentanil 0.1μLg/kg and propofol 1〜2 mg/kg were slowly injected intravenously;while in group PK,esketamine 0.15 mg/kg and propofol 1〜2 mg/kg were slowly injected intravenously.Record the HR,MAP and SpO_(2)of the two groups at each time point,Observe the body movement reaction during the examination,The dosage of propofol,microscopic examination time,recovery time,and the incidence of propofol injection pain,choking,respiratory depression(SpO_(2)<90%),hypotension,nausea and vomiting were recorded.[Results]There was no significant difference HR,MAP and SpO_(2)between the two groups at each time point(P>0.05),There was no significant difference in dosage of propofol andrecovery time between the two groups(P>0.05),There was no significant difference in the nausea and vomiting,incidence of body movement and injection pain between the two groups(P>0.05),Compared with PK group,the incidence of respiratory depression,choking and hypotension in PS group was significantly higher(P<0.05).[Conclusion]Esketamine combined with propofol can achieve the sedative and analgesic effect of painless cystoscopy,with less adverse reactions such as respiratory depression,choking and hypotension,which is worthy of clinical promotion.

关 键 词：艾司氯胺酮 无痛膀胱镜 丙泊酚 舒芬太尼 

分 类 号：R694[医药卫生—泌尿科学]