丙泊酚复合依托咪酯对老年无痛胃镜患者诱导期末梢灌注指数的影响  

Effect of Propofol Combined with Etomidate on Peripheral Perfusion Index in Elderly Patients with Painless Gastroscopy During Induction

作　　者：陈瀚燊 肖微 汤奕洁 陈彦青[2] CHEN Hanshen;XIAO Wei;TANG Yijie;CHEN Yanqing(Department of Anesthesiology,The First Affiliated Hospital of Fujian Medical University,Fuzhou 350005,China;Department of Anesthesiology,Shengli Clinical Medical College of Fujian Medical University,Fujian Provincial Hospital,Fuzhou 350013,China)

机构地区：[1]福建医科大学附属第一医院麻醉科,福州350005 [2]福建医科大学省立临床医学院,福建省立医院麻醉科,福州350013

出　　处：《福建医科大学学报》2022年第4期347-350,共4页Journal of Fujian Medical University

摘　　要：目的分析丙泊酚、依托咪酯单药使用或联合使用对诱导期末梢灌注指数(PI)及相关指标的影响,探讨老年无痛胃镜检查中安全、高效的给药方法。方法选取2017年10月—2018年2月择期接受胃镜检查的老年患者200例,年龄61~80岁,美国麻醉医师协会分级Ⅰ~Ⅱ。随机将患者分为丙泊酚组(P组)、依托咪酯组(E组)、丙泊酚+依托咪酯组(PE组)、依托咪酯+丙泊酚组(EP组)、丙泊酚与依托咪酯混合液组(M组),每组40例。记录各组诱导前后的PI值、平均动脉压(MAP)、血氧饱和度(SpO_(2))以及诱导后肌颤搐例数。结果P组诱导后的PI、MAP和SpO_(2)下降幅度均明显大于E组(P<0.05),PE组、EP组、M组与E组比较,差别均无统计学意义(P>0.05)。结论丙泊酚与依托咪酯联合使用,不仅具备单药的优势,且对PI的影响小,对于老年患者而言是一种对循环系统干扰较小的安全、稳定的麻醉方式。Objective To analyze the effects of propofol and etomidate alone or in combination on peripheral perfusion index(PI)and related indexes during induction period,thus to explore a safer and more efficient administration method for painless gastroscopy in the elderly.Methods A total of 200 elderly patients undergoing elective gastroscopy from October 2017 to February 2018 were selected.The age range of the patients was 61-80 years old.The grouping was based on the ASA(American Medical Association grading)Ⅰ-Ⅱ,and they were randomly divided into the propofol group(P group),etomidate group(E group),propofol+etomidate group(PE group),etomidate+propofol group(EP group),propofol and etomidate mixed solution(M group).Each group included 40 elderly patients.The decrease in PI,mean artery pressure(MAP)and oxygen saturation(SpO_(2))and muscular tremors in each group after induction wererecorded.Results The decrease of PI,MAP and SpO_(2) in group P after induction was significantly greater than that in E group(P<0.05).The decrease of PI in PE,EP and M group was similar than that in E group(P>0.05).Conclusion The combination of propofol and etomidate not only has the advantages of each drug,but also has less impact on PI compared with other administration methods.It is a safer and more stable anesthesia method with less interference on the circulatory system for elderly patients than others.

关 键 词：胃镜 镇静 末梢灌注指数 丙泊酚 依托咪酯 

分 类 号：R614[医药卫生—麻醉学]