异丙酚复合小剂量氯胺酮用于胃镜检查的临床观察

Efficacy and safety of propofol combined with low dose ketamine in gastroscopy

目的应用异丙酚和氯胺酮加异丙酚静脉麻醉开展无痛胃镜检查,对两种方法的效果和安全性进行临床对照观察。方法60例接受胃镜检查患者随机分为异丙酚组(P组)和氯胺酮加异丙酚组(KP组)各30例,P组患者诱导用异丙酚0.8 mg/kg,在6 s内匀速静注,随后以0.5 mg/(kg.min)的速度维持,同时,为了减轻异丙酚对小血管局部性的疼痛刺激,每20ml异丙酚加入利多卡因20 mg。KP组一次性静注氯胺酮0.2 mg/kg,随后以P组相同方法给予异丙酚。观察术中血压、心率、呼吸和脉搏血氧饱和度,记录用药量、镇静镇痛效果、术后清醒时间、离院时间。结果KP组异丙酚诱导用量较异丙酚组明显减少(P<0.05),术中生命体征变化在KP组较异丙酚组更平稳;术后清醒时间及离院时间两组无显著性差异(P>0.05)。无明显不良反应。结论异丙酚复合小剂量氯胺酮用于胃镜检查是安全有效的。

Objective To investigate the efficacy and safety of propofol intravenous anesthesia combined with ketamine in gastroscopy. Methods Sixty outpatients undergoing gastroscopy were randomly divided into two groups（30 each）. Propofol group（group P） underwent anesthesia induced by intravenous injection of propofol 0.8 mg/kg in 6 seconds followed by intravenous infusion of propofol at 0.5 mg/（kg·min） to which was added lidocaine 20 mg per 20 ml of propofol. Propofol plus ketamine group（group PK）received ketamine 0.2 mg/kg intravenously before propofol infusion the same as group P. Blood pressure, heart rate, breath, and oxygen saturation of blood were monitored. Drug dosage, sedative and analgesic effects, time of awakening, and time of discharge were recorded. Results In group PK, the induction dosage of propofol was lower and the vital signs were steadier than in group P（P 〈 0.01 ）. There were no differences in time of awakening and time of discharge between the two groups （ P 〉0.05）.Omdusitm Propofol plus low dose ketaminc in gastroscopy is safe and effective.