小剂量艾司氯胺酮联合环泊酚在老年患者无痛胃肠镜检查中的临床应用

Clinical application of low-dose esketamine combined with cyclopofol in painless gastrointestinal endoscopy in elderly patients

目的观察小剂量艾司氯胺酮联合环泊酚在老年患者无痛胃肠镜检查中的应用效果。方法选取2022年4月至2022年6月行无痛胃镜检查的老年患者60例,随机数字表法分为对照组和观察组各30例。对照组给予环泊酚静脉麻醉,观察组给予小剂量艾司氯胺酮联合环泊酚静脉麻醉。记录两组患者在进入检查室后(T_(0))、检查开始前(T_(1))、置入胃镜后(T_(2))、肠镜开始前(T_(3))、置入肠镜后(T_(4))和操作结束时(T_(5))的平均动脉压(MAP)和心率(HR),分析并比较两组在胃肠镜检查过程中的麻醉效果、患者满意度评分及术中不良反应的发生率。结果观察组患者环泊酚的用量、苏醒时间及术后定向力恢复时间均短于对照组,满意度评分高于对照组,差异有统计学意义(P<0.05)。在T_(3)~T_(5)时间点,对照组患者MAP显著低于T_(0)时(P<0.05),T_(4)及T_(5)时间点,观察组患者MAP显著低于T_(0)时(P<0.05);T_(1)~T_(4)各时间点观察组患者MAP显著高于对照组患者(P<0.05)。观察组患者不良反应发生率显著低于对照组(P<0.05)。结论小剂量艾司氯胺酮联合环泊酚麻醉应用于无痛胃肠镜检查时能够提高麻醉效果,减少麻醉药物用量,缩短患者术后苏醒时间,提高患者满意度,值得临床推广应用。

Objective To observe the application effect of cyclopofol combined with low-dose esketamine in elderly people undergoing painlessgastroenteroscopy.Methods Sixty elderly patients from Tangshan peoples′s hospital who underwent painless gastroenteroscopy from April 2022 to June 2022 were selected.The patients were divided into a control group and an observation group by using random number table method,30 in each group.The control groupwas anesthetized with cyclopofol,and the observation group was anesthetized with cyclopofol combined with low-dose esketamine.Mean arterial pressure(MAP)and heart rate(HR)were recorded at the time of entering the examination room(T_(0)),before the start of the examination(T_(1)),after the insertion of the gastroscope(T_(2)),before the start of the colonoscopy(T_(3)),after the insertion of the colonoscopy(T_(4))and at the end of the operation(T_(5))were recorded.The anesthesia effect,patient satisfaction score and the incidence of intraoperative adverse reactions during gastroenteroscopy were analyzed and compared between the two groups.Results Compared with the control group,the dosage of cyclopofol,recovery time and postoperative orientation recovery time were shorter and the satisfaction scorewas higher in the observation group(P<0.05).At T_(3)~T_(5)time points,the MAP of patients in the control group was significantly lower than that at time T_(0)(P<0.05),and at time points T_(4)and T_(5),the MAP of patients in the observation group was significantly lower than that at time T_(0)(P<0.05).At each time point from T_(1)to T_(4),the MAP in the observation group was significantly higher than that in the control group(P<0.05).During the process of gastroenteroscopy,the incidence of adverse events in the observation group was significantly lower than that in the control group(P<0.05).Conclusions Low-dose esketamine combined with cyclopofol anesthesia can improve the anesthesia effect during painless gastrointestinal endoscopy.It can effectively reduce the dosage of anesthetics,shorten the recovery time after gastroenteroscopy,and improve the patients′satisfaction.It has clinical promotion significance.