丙泊酚联合艾司氯胺酮在无痛胃肠镜检查中的应用效果

Effect of Propofol Combined with Esketamine in Painless Gastroenteroscopy

目的:观察丙泊酚联合艾司氯胺酮在无痛胃肠镜检查中的应用效果。方法:采用前瞻性研究方法,将2020年6月-2021年3月在南通大学附属东台医院麻醉科接受无痛胃肠镜检查的82例患者纳入研究,按随机双盲法分为两组,各41例。对照组采用丙泊酚麻醉,研究组采用丙泊酚联合艾司氯胺酮麻醉。比较两组麻醉效果、呼吸循环功能、认知功能及不良反应。结果:研究组麻醉效果明显优于对照组(P<0.05)。T_(1)、T_(3)时,两组呼吸频率(RR)、血氧饱和度(SpO_(2))、平均动脉压(MAP)、心率(HR)比较,差异均无统计学意义(P>0.05);T_(2)时,两组RR、SpO_(2)、MAP、HR较T_(1)时均有不同程度下降(P<0.05),研究组RR、SpO_(2)、MAP、HR均高于对照组(P<0.05)。麻醉后1、6、12 h,研究组简易精神状态检查量表(MMSE)评分均高于对照组(P<0.05)。两组不良反应发生率相比,差异无统计学意义(P>0.05)。结论:丙泊酚联合艾司氯胺酮在无痛胃肠镜检查中应用效果和安全性好,可以有效保持患者呼吸循环功能的稳定,可能会降低术后认知功能障碍的发生率,具有临床推广意义。

Objective:To observe the effect of Propofol combined with Esketamine in painless gastroenteroscopy.Method:Using prospective research methods,82 patients who underwent painless gastrointestinal endoscopy in Department of Anesthesiology,Dongtai Hospital Affiliated to Nantong University from June 2020 to March 2021 were included in the study,and were divided into two groups according to a randomized double-blind method,with 41 cases in each group.The control group was anesthetized with Propofol,and the study group was anesthetized with Propofol combined with Esketamine.The anesthesia effect,respiratory and circulatory function,cognitive function and adverse reactions of the two groups were compared.Result:The anesthesia effect of the study group was significantly better than that of the control group(P<0.05).At T_(1),T_(3),the differences in respiratory rate(RR),blood oxygen saturation(SpO_(2)),mean arterial pressure(MAP)and heart rate(HR)between the two groups were not statistically significant(P>0.05);at T_(2),the RR,SpO_(2),MAP,and HR of the two groups were decreased to varying degrees compared with those at T_(1)(P<0.05).RR,SpO_(2),MAP and HR in the study group were higher than those in the control group(P<0.05).1,6 and 12 h after anesthesia,the MMSE scores of the study group were all higher than those of the control group(P<0.05).There was no statistically significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:Propofol combined with Esketamine has a good application effect in painless gastrointestinal endoscopy,can effectively maintain the stability of the patient’s respiratory and circulatory function,and will not increase the occurrence of cognitive dysfunction,has good safety,and has clinical promotion significance.