环泊酚复合阿芬太尼用于老年患者无痛膀胱镜检查的有效性和安全性  

Efficacy and safety of ciprofol plus alfentanil for painless cystoscopy in elderly patients

作　　者：周广伟 张岚 宁庚 王英 张满和 ZHOU Guangwei;ZHANG Lan;NING Geng;WANG Ying;ZHANG Manhe(Department of Anesthesiology,Tangshan Workers’Hospital,Hebei Tangshan 063000,China)

机构地区：[1]唐山市工人医院麻醉二科,河北唐山063000

出　　处：《中国医院药学杂志》2024年第13期1564-1568,共5页Chinese Journal of Hospital Pharmacy

基　　金：河北省卫生健康委医学科研课题(编号:20221798)。

摘　　要：目的:观察环泊酚复合阿芬太尼用于老年患者无痛膀胱镜检查的有效性和安全性。方法:选取150例拟在唐山市工人医院行无痛膀胱镜检查的老年患者,采用随机数字表法分为环泊酚组(观察组,n=75)和丙泊酚组(对照组,n=75)。麻醉诱导:两组均静脉注射阿芬太尼5μg·kg^(-1),2 min后观察组泵注环泊酚0.3 mg·kg^(-1),对照组泵注丙泊酚1.5 mg·kg^(-1)。麻醉维持:观察组持续泵注环泊酚0.8 mg·kg^(-1)·h^(-1),对照组持续泵注丙泊酚4 mg·kg^(-1)·h^(-1)。记录两组患者有效性指标:麻醉诱导时长、手术操作时长、完全清醒时长、麻醉总时长,体动患者例数与发生率;安全性指标:平均动脉压、心率、呼吸频率,进一步比较注射痛、低血压、心动过缓、辅助通气、苏醒期谵妄患者例数与发生率来评价安全性。结果:两组患者有效性评价指标比较差异无统计学意义(P>0.05)。观察组对平均动脉压的抑制作用弱于对照组,差异有统计学意义(P<0.05)。两组药物对心率和呼吸频率的作用效果比较无明显差异(P>0.05)。注射痛、辅助通气、低血压、心动过缓例数与发生率比较,观察组均低于对照组(P<0.05),苏醒期谵妄发生率两组比较差异无统计学意义(P>0.05)。结论:环泊酚复合阿芬太尼可安全有效的用于老年患者无痛膀胱镜检查,环泊酚对维持呼吸和循环系统的稳定更具优势,不良反应发生率更低。OBJECTIVE To explore the efficacy and safety of ciprofol plus alfentanil for painless cystoscopy in elderly patients.METHODS A total of 150 elderly patients undergoing painless cystoscopy were randomized into two groups of ciprofol(observation,n=75)and propofol(control,n=75).Anesthesia induction:Both groups received an intravenous injection of alfentanil 5μg·kg^(-1).After 2 min,observation group received a continuous infusion of ciprofol 0.3 mg·kg^(-1)while control group had a continuous infusion of propofol 1.5 mg·kg^(-1).Anesthesia maintenance:0.8 mg·kg^(-1)·h^(-1) ciprofol and 4 mg·kg^(-1)·h^(-1) propofol were injected intravenously in observation and control groups respectively.Then duration of anesthesia induction,operative duration,duration of anesthesia awakening,total duration of anesthesia,number and incidence of physical activity were recorded.And the safety parameters included mean arterial pressure(MAP),heart rate(HR),respiratory rate(RR)and number and incidence of injection pain,hypotension,bradycardia,assisted ventilation and emergence delirium(ED).RESULTS No statistically significant inter-group difference existed in effectiveness evaluation parameters.Inhibitory effect of MAP was obviously weaker in observation group than that in control group(P<0.05).No significant inter-group difference existed in the effects of HR and RR(P>0.05).The number and incidences of injection pain,assisted ventilation,hypotension and bradycardia were lower in observation group than those in control group(P<0.05).No significant inter-group differences existed in number and incidences of ED(P>0.05).CONCLUSION Ciprofol plus alfentanil may be safely and effectively applied for painless cystoscopy in elderly patients.Ciprofol offers the advantages of maintaining respiratory and circulatory stabilities with a lower incidence of adverse reactions.

关 键 词：环泊酚 阿芬太尼 老年 膀胱镜 麻醉 

分 类 号：R614.24[医药卫生—麻醉学] R969.4[医药卫生—外科学]