丙泊酚中长链脂肪乳复合利多卡因用于无痛胃镜检查术中的临床观察

Clinical observation of propofol formulated in a medium-and long-chain triglyceride emulsion combined with lidocaine in painless gastroscopy

目的：观察丙泊酚中长链脂肪乳注射液复合利多卡因在无痛胃镜检查中的临床效果。方法选择行无痛胃镜检查术患者80例，随机分为4组，每组20例，A组为丙泊酚长链脂肪乳组，B组为丙泊酚长链脂肪乳＋利多卡因组，C组为丙泊酚中长链脂肪乳组，D组为丙泊酚中长链脂肪乳＋利多卡因组。麻醉诱导后，待患者呼之不应、睫毛反射消失后实施胃镜检查。记录2组患者注药前5 min、检查开始即刻、检查结束后5 min的心率、平均动脉压、脉搏氧饱和度及不良反应发生情况。结果4组患者年龄、体重、检查时间、苏醒时间及起效时间比较差异无统计学意义。麻醉后4组患者平均动脉压、脉搏氧饱和度较麻醉前均有所下降，心率反射性增快，差异有统计学意义（P＜0．05）。4组患者呛咳恶心呕吐、体动、呼吸抑制等不良反应差异无统计学意义（P＞0．05）；A 组患者注射痛显著高于其他3组，B组和C组注射痛发生率相似，D组的发生率最低（P＜0．05）。结论丙泊酚中长链脂肪乳注射液复合利多卡因应用于无痛胃镜检查术起效快，苏醒时间短，呼吸抑制轻，注射痛不明显，可获得满意的临床效果。

Objective To observe the clinical efficacy of propofol formulated in a medium-and long-chain tri-glyceride emulsion combined with lidocaine in painless gastroscopy.Methods A total of 80 patients undergoing painless gastroscopy were randomly divided into 4 groups （ n=20） , including Group A injected with propofol formulated in a long chain triglyceride （ LCT） emulsion, Group B with LCT plus lidocaine, Group C with propofol formulated with a medium-and long-chain triglyceride （ MCT/LCT） emulsion, and Group D with MCT/LCT plus lidocaine.After induction of anesthesia, gastroscopy was performed when patients could not give any response and eyelash reflex disappeared.Then, heart rate, mean arterial pressure, SpO2 , adverse reactions were observed 5 min before anesthesia, immediately after, during and 5 min after examination.Results No significant difference were found in age, body weight, examination time, recovery time and onset time among these four groups.After anesthesia, patients in each groups produced remark-ably lower levels of MAP and SpO2 than their corresponding quatities before anesthesia （P〈0.05）.No statistical differ-ence was found in cough, nausea, vomiting, body movement, and respiratory depression among these four groups （ P〉0.05）.Patients in Group A reported the strongest injection pain, followed by those in Groups B and C who showed a sim-ilar incidence, and then those in Group C （P〈0.05）.Conclusion Propofol formulated in an MCT/LCT emulsion combined with lidocaine can be applied for painless gastroscopy, which has a rapid onset, short recovery time, mild re-spiratory depression, and not obvious injection pain, leading to satisfactory clinical efficacy.