依托咪酯联合瑞芬太尼在老年患者无痛肠镜麻醉中的应用

Application of Etomidate Combined with Remifentanil in Painless Enteroscopy Anesthesia in Elderly Patients

目的探讨在老年无痛肠镜麻醉中采用依托咪酯联合瑞芬太尼方案的效果。方法选取2021年1月—2022年12月泰兴市中医院收治的115例无痛肠镜检查患者为研究对象,根据麻醉方案不同分为两组,对照组(n=57)予丙泊酚联合瑞芬太尼方案,观察组(n=58)予依托咪酯联合瑞芬太尼方案,比较两组麻醉及检查情况,评估患者麻醉前后生命体征改变,并对比不良反应发生率。结果观察组麻醉起效、置镜操作、麻醉苏醒时间均较对照组短,差异有统计学意义(P均<0.05)。麻醉后,观察组平均动脉压(82.25±6.14)mmHg、心率(69.48±4.63)次/min、血氧饱和度(97.33±1.79)%,优于对照组的(79.02±6.32)mmHg、(65.55±4.27)次/min、(95.24±1.72)%,差异有统计学意义(t=2.778、4.730、6.383,P均<0.05)。观察组注射痛、呼吸抑制发生率低于对照组,差异有统计学意义(P均<0.05)。结论对老年无痛肠镜检查患者予依托咪酯联合瑞芬太尼麻醉效果确切,能维持循环稳定,减少呼吸抑制,不良反应发生风险低。

Objective To explore the effect of using etomidate combined with remifentanil protocol in painless enteroscopy anesthesia in elderly.Methods A total of 115 patients with painless enteroscopy admitted to the hospital from January 2021 to December 2022 were selected as study objects and grouped into two groups according to different anesthesia protocols,the control group(n=57)was given propofol combined with remifentanil protocol,and the observation group(n=58)was given etomidate combined with remifentanil protocol.The anesthesia and examination of the two groups were compared,the changes in vital signs of patients before and after anesthesia were assessed,and the incidence of adverse reactions was compared.Results The onset of anesthesia,microscope placement,and anesthesia awakening time were shorter in the observation group than those in the control group,and the differences were statistically significant(all P<0.05).After anesthesia,the mean arterial pressure(82.25±6.14)mmHg,heart rate(69.48±4.63)beats/min,and oxygen saturation(97.33±1.79)% in the observation group were better than those in the control group(79.02±6.32)mmHg,(65.55±4.27)beats/min,(95.24±1.72)%,and the differences were statistically significant(t=2.778,4.730,6.383,all P<0.05).The incidence of injection pain and respiratory depression in the observation group were lower than those in the control group,and the differences were statistically significant(both P<0.05).Conclusion The effect of giving etomidate combined with remifentanil anesthesia to elderly patients with painless colonoscopy is exact,which can maintain circulatory stability,reduce respiratory depression,and have a low risk of adverse reactions.