艾司氯胺酮复合丙泊酚麻醉应用于儿童无痛胃肠镜检查的效果

Efficacy of esketamine combined with propofol in children undergoing painless gastrointestinal endoscopy

目的 观察艾司氯胺酮复合丙泊酚麻醉应用于儿童无痛胃肠镜检查的效果。方法接受无痛胃肠镜检查的患儿100例,年龄3~12岁,随机分为两组,每组50例。麻醉方法:E组依次静脉注射艾司氯胺酮0.2 mg/kg和丙泊酚1.5~2.5 mg/kg;F组依次静脉注射芬太尼1μg/kg和丙泊酚1.5~2.5 mg/kg。待患儿睫毛反射消失后开始胃肠镜检查。记录入室时(T0)、麻醉后即刻(T1)、入镜后3 min(T2)和出室时(T3)的MAP、HR和SpO_(2)。记录两组患儿胃肠镜检查时间、麻醉苏醒时间、体动次数和丙泊酚用量,评估患儿术后面部表情疼痛量表(FPS)评分,观察不良反应发生情况,随访手术医师的满意度。结果 与T0时比较,两组患儿T1~T3时的MAP和HR降低(P<0.05),T1、T2时的SpO_(2)降低(P<0.05)。E组患儿T1~T3时的MAP、HR和SpO_(2)高于F组(P<0.05)。E组麻醉苏醒时间、体动次数、丙泊酚用量、FPS评分和不良反应发生率少于F组(P<0.05)。手术医师对E组麻醉的非常满意率高于F组(P<0.05)。结论 与芬太尼复合丙泊酚比较,艾司氯胺酮复合丙泊酚麻醉能更好地维持无痛胃肠镜检查儿童的循环稳定,减少丙泊酚用量,提高手术医师对麻醉的满意度。

Objective To observe the efficacy of esketamine combined with propofol in children undergoing painless gastrointestinal endoscopy.Methods A total of 100children aged 3-12years old undergoing painless gastrointestinal endoscopy were randomly divided into two groups with 50cases each.Group E was anesthetized with intravenous injection of esketamine 0.2mg/kg and propofol 1.5-2.5mg/kg,while group F was anesthetized with intravenous injection of fentanyl 1μg/kg and propofol 1.5-2.5mg/kg.The MAP,HR and SpO_(2) were recorded at the time points of entering the operation room(T0),after anesthesia(T1),3minutes after endoscope insertion(T2)and leaving the operation room(T3).The operation time,recovery time,body motion reaction,the consumption of propofol,facial pain scale(FPS)score,and the incidence of adverse reactions were recorded.The satisfaction rate of the surgeon was followed up.Results Compared with T0,MAP and HR were decreased at T1,T2and T3and SpO_(2) was decreased at T1and T2in the two groups(P<0.05).MAP,HR and SpO_(2)at T1,T2and T3were significantly higher in group E than those in group F(P<0.05).The recovery time,body motion reaction,propofol consumption,FPS score and the incidence of adverse reactions were significantly less in group E than those in group F(P<0.05).The satisfaction rate of the surgeon in group E was significantly higher than that in group F(P<0.05).Conclusion Compared to fentanyl combined with propofol,anesthesia with esketamine combined with propofol for the painless gastrointestinal endoscopy in children can more effectively maintain the circulation stability,reduce the consumption of propofol,and improve the surgeon's satisfaction.