分析艾司氯胺酮联合丙泊酚用于无痛支气管镜检查麻醉的安全性及有效性

Analyzing the Safety and Efficacy of Esketamine Combined with Propofol for Painless Bronchoscopy Anesthesia

目的分析艾司氯胺酮联合丙泊酚用于无痛支气管镜检查麻醉的安全性及有效性。方法单纯随机选取2022年10月-2023年4月山东省烟台市北海医院收治的100例采用无痛支气管镜检查的患者为研究对象,并依据随机数表法将其分成对照组和观察组,每组50例。观察组采用艾司氯胺酮联合丙泊酚麻醉,对照组采用舒芬太尼联合丙泊酚的麻醉。对比两组在T0(实施麻醉前)、T1(无痛支气管镜置管)、T2(支气管镜经过声门)、T3(支气管镜抵达隆突)、T4(纤维支气管镜取出)、T5(患者苏醒)、T6(观察期结束)时的平均动脉压、心率和血氧饱和度,麻醉效果以及不良反应发生情况。结果在T2、T3、T4阶段,观察组平均动脉压、心率比高于对照组,差异有统计学意义(P均<0.05)。在T3、T4阶段,观察组血氧饱和度高于对照组,差异有统计学意义(P均<0.05)。观察组患者的呛咳发生率、麻醉苏醒时间、麻醉清醒时间均短于对照组,差异有统计学意义(P均<0.05)。观察组不良反应总发生率为4.00%,低于对照组的16.00%,差异有统计学意义(χ^(2)=7.324,P<0.05)。结论艾司氯胺酮和丙泊酚的联合应用能提供稳定、有效的麻醉,减少不良反应,提高无痛支气管镜检查的安全性和舒适性。

Objective To analyze the safety and effectiveness of esketamine combined with propofol for painless bron-choscopy anesthesia.Methods 100 patients for painless bronchoscopy admitted to Yantai Beihai Hospital from Octo-ber 2022 to April 2023 were selected simple randomly as study objects,and they were divided into a control group and an observation group of 50 patients each according to the method of random number table.The observation group was anesthetized with esketamine combined with propofol,and the control group was anesthetized with sufentanil com-bined with propofol.The mean arterial pressure,heart rate and oxygen saturation of two groups of patients at T0(be-fore anesthesia),T1(painless bronchoscopy tube placement),T2(bronchoscopy passing through the glottis),T3(bron-choscopy reaching the protuberance),T4(fiberoptic bronchoscopy removal),T5(patient awakening),and T6(end of ob-servation period),as well as anesthesia effects and adverse reaction occurrence were compared between the two groups.Results In stages T2,T3,and T4,the mean arterial pressure and heart rate in the obervation group were higher than those in the control group,and the differences were statistically significant(all P<0.05).In the T3 and T4 stages,the blood oxygen saturation,and the differences were statistically significant(both P<0.05).The incidence of coughing and time of awakening from anesthesia,the time of waking up from anesthesia of the patients in the observa-tion group were shorter than those of the control group,and the differences were statistically significant(all P<0.05).The total incidence of adverse reactions in the observation group was 4.00%,lower than the control group's 16.00%,and the difference was statistically significant(χ^(2)=7.324,P<0.05).Conclusion The combined application of esket-amine and propofol can provide stable and effective anesthesia,reduce adverse reactions,and improve the safety and comfort of painless bronchoscopy.