性别因素对艾司氯胺酮复合环泊酚在门诊无痛胃肠镜检查麻醉效果的疗效观察

Effect of gender on the anesthetic effect of esketamine combined with ciprofol in outpatients undergoing painless gastrointestinal endoscopy

目的探讨性别因素对艾司氯胺酮复合环泊酚在门诊无痛胃肠镜检查麻醉效果的影响。方法选取2023年6—11月首都医科大学宣武医院择期行门诊无痛胃肠镜检查的患者200例,根据性别分为M组(男性)和F组(女性),每组100例。患者的麻醉诱导采用静脉注射艾司氯胺酮0.3 mg/kg复合环泊酚0.4 mg/kg,术中持续静脉输注环泊酚0.8~1.5 mg/(kg·h),维持改良警觉/镇静评分(modified observer’s assessment of alert/sedation score,MOAAS)≤1分且脑电双频指数(bispectral index,BIS)40~60。比较两组患者的一般情况、术中及术后不良反应发生情况、检查时间和满意度等。结果200例患者平均年龄(43.4±10.2)岁。与M相比较,F组术中呛咳发生率较高(21.00%比8.00%)、术后头晕发生率较高(18.00%比5.00%)、分泌物增多及恶心呕吐发生率较高(9.00%比2.00%,12.00%比2.00%),离院时间延长[(25.70±6.73)min比(22.53±6.29)min],差异均有统计学意义(P<0.05)。结论艾司氯胺酮复合环泊酚用于男性门诊无痛胃肠镜检查的麻醉效果优于女性。可酌情减少女性患者镇痛药物使用剂量,并预防性给予止吐药物,以减轻性别差异带来的不适。

Objective To explore the influence of gender on the anesthetic effect of esketamine combined with ciprofol in outpatients undergoing painless gastrointestinal endoscopy.Methods A total of 200 patients who underwent elective painless gastrointestinal endoscopy in Xuanwu Hospital of Capital Medical University from June to November 2023 were selected,and were divided into group M(male)and group F(female)according to gender,with 100 cases in each group.The patients were induced by intravenous injection of esketamine 0.3 mg/kg combined with cyclophosphamide 0.4 mg/kg,and continuous intravenous infusion of ciprofol 0.8~1.5 mg/(kg·h),maintain the modified observer's assessment of alert/sedation score(MOAAS)less than one point and the bispectral index(BIS)40~60.The general status,occurrence of intraoperative and postoperative adverse reactions,examination time and satisfaction of the two groups were compared.Results The mean age of the 200 patients was(43.4±10.2)years.Compared with group M,the incidence of choking cough during surgery(21.00%vs.8.00%),the incidence of dizziness after surgery(18.00%vs.5.00%),the rate of increased secretion(9.00%vs.2.00%),rate of nausea and vomiting(12.00%vs.2.00%)was higher in group F,and the time of discharge from hospital[(25.70±6.73)min vs.(22.53±6.29)min]was longer in group F,the differences were statistically significant(P<0.05).Conclusions The anesthetic effect of esketamine combined with ciprofol in male outpatients undergoing painless gastrointestinal endoscopy is better than that of the female.The dosage of analgesic drugs used by female patients can be reduced as appropriate,and antiemetic drugs can be given preventively to alleviate the discomfort caused by gender differences.