艾司氯胺酮在无痛纤支镜检查患者中的应用效果及对体动反应的影响研究

Study of the Effect of Esketamine in Patients with Painless Fiberoptic Bronchoscopy and Its Effect on Body Dynamic Reaction

目的探讨艾司氯胺酮在无痛纤支镜检查中的应用效果及对体动反应的影响。方法选择2023年1月至11月在九江市第三人民医院行无痛纤支镜检查的98例患者,按随机数字表法分为对照组(n=49)与研究组(n=49)。对照组用舒芬太尼联合丙泊酚麻醉,研究组用艾司氯胺酮联合丙泊酚麻醉。对比两组不同时间点心率(HR)、血氧饱和度(SpO_(2))、平均动脉压(MAP)和不良反应、苏醒时间、体动反应、定向力恢复时间。结果两组麻醉前(T0)时HR、MAP、SpO_(2)比较,差异无统计学意义(P>0.05),与T0时相比,麻醉后(T1)时对照组HR、SpO_(2)、MAP明显降低,研究组各指标较对照组高,差异有统计学意义(P<0.05);而气管镜插入声门时(T2)对照组HR、SpO_(2)、MAP高于T1时,研究组T2时各指标检测值低于对照组,(P<0.05);研究组定向力恢复时间短于对照组,呛咳、低血压、体动反应、呼吸抑制发生比例低于对照组,差异有统计学意义(P<0.05);两组苏醒时间对比,差异无统计学意义(P>0.05)。结论艾司氯胺酮可维持无痛纤支镜检查时血流动力学稳定,减少低血压与体动反应等不良反应发生,促进患者康复。

Objective To explore the application effect of esketamine in painless bronchoscopy patients and its impact on body movement response.Methods 98 patients who underwent painless bronchoscopy examination at Jiujiang Third People's Hospital from January to November 2023 were randomly divided into a control group(n=49)and a study group(n=49)using a random number table method.The control group was anesthetized with sufentanil and propofol,while the study group was anesthetized with esketamine and propofol.Heart rate(HR),blood oxygen saturation(SpO_(2)),mean arterial pressure(MAP),adverse reactions,body motor response,recovery time and orientation recovery time were compared between the two groups at different time points.Results There were no statistical significances in HR,MAP and SpO_(2) between the two groups before anesthesia(T0)(P>0.05).Compared with T0,HR,SpO_(2) and MAP in the control group were significantly decreased after anesthesia(T1),and the indexes in the study group were higher than those in the control group,with statistical significance(P<0.05).When the tracheoscope was inserted into the glottis(T2),HR,SpO_(2) and MAP in the control group were higher than T1,and the test values of each index in the study group at T2 were lower than those in the control group(P<0.05).The recovery time of orientation in the study group was shorter than that in the control group,and the incidence of cough,hypotension,body motor reaction and respiratory depression were lower than those in the control group,the difference were statistically significant(P<0.05);while the recovery time between the two groups was not statistically significant(P>0.05).Conclusion Esketamine can maintain hemodynamic stability during painless bronchoscopy,reduce adverse reactions such as hypotension and body movement,and promote patient recovery.