小剂量羟考酮复合依托咪酯、丙泊酚在无痛结肠镜诊疗中的疗效观察

Efficacy of low-dose oxycodone combined with etomidate and propofol in painless colonoscopy

目的探讨小剂量羟考酮(0.05 mg/kg)注射液复合依托咪酯、丙泊酚在无痛结肠镜诊疗中的应用效果。方法选取2019年7月至2020年2月首都医科大学宣武医院收治的92例行无痛结肠镜诊疗患者,采用随机数字表法分为两组,每组46例。Q组给予盐酸羟考酮注射液+依托咪酯+丙泊酚,D组给予地佐辛+依托咪酯+丙泊酚。比较两组麻醉前(T1)、肠镜进入肛门时(T2)、肠镜过肝曲时(T3)、唤醒时(T4)的呼吸频率(respiratory rate,RR)、HR、SpO2、SBP、DBP、MAP;记录结肠镜检查时间、苏醒时间、丙泊酚用量,以及患者满意度评分;记录不良反应,包括术中体动、呼吸抑制及术后头晕、疼痛、恶心呕吐、视物模糊、嗜睡,比较两组总不良反应发生率。结果两组T2、T3、T4时的HR、MAP、RR、SBP、DBP较T1时均显著降低(P<0.05),而4个时间点的SpO2差异均无统计学意义(P>0.05)。Q组丙泊酚用量明显低于D组[(125.3±20.1)mg比(148.4±29.8)mg,P<0.05],总不良反应发生率明显低于D组(45.7%比58.7%,P<0.05)。结论小剂量羟考酮(0.05 mg/kg)复合依托咪酯、丙泊酚应用于无痛结肠镜检查中较小剂量地佐辛(0.05 mg/kg)复合依托咪酯、丙泊酚,丙泊酚总用量更少,总不良反应发生率低,临床效果更满意。

Objective To investigate the efficacy of low-dose oxycodone combined with etomidate and propofol in painless colonoscopy.Methods A total of 92 patients underwent painless colonoscopy admitted to Xuanwu Hospital from July 2019 to February 2020 were randomly divided into two groups.The observation group(group Q)was given oxycodone hydrochloride injection,etomidate,propofol.And the control group(group D)were given dizocine,etomidate,propofol.The HR,SpO2,respiratory rate(RR),systolic blood pressure(SBP),diastolic blood pressure(DBP)and mean arterial pressure(MAP)at the time before anaesthesia(T1),when colonoscope entered anus(T2),when colonoscope passed hepatic flexure of colonxion(T3),when awakened(T4)were compared between the two groups.The time of colonoscopy and recovery,the amount of propofol,and the patient satisfaction were recorded.Adverse reactions including intraoperative body movement,respiratory depression and postoperative dizziness,pain,nausea and vomiting,blurred vision,drowsiness and the total incidence of adverse reactions were compared between the two groups.Results The HR,MAP,SBP,DBP and RR at the time of T2,T3 and T4 in the two groups were all significantly lower than those of T1(P<0.05).However,there was no statistical difference in SpO2 at four time points(P>0.05).The dosage of propofol in group Q was significantly lower than that in group D[(125.3±20.1)mg vs.(148.4±29.8)mg,P<0.05].Moreover,the incidence of total adverse reactions in group Q was significantly lower than that in group D(45.7%vs.58.7%,P<0.05).Conclusions In painless colonoscopy,low-dose oxycodone(0.05 mg/kg)combined with etomidate and propofol,compared with low-dose dizocine(0.05 mg/kg)combined with etomidate and propofol,the total amount of propofol was less,the total incidence of adverse reactions was lower,and the clinical effect was more satisfactory.