小剂量艾司氯胺酮复合环泊酚在老年患者超声胃镜检查中的临床应用

Clinical application of low-dose esketamine combined with ciprofol in elderly patients undergoing endoscopic ultrasonography

目的 探讨小剂量艾司氯胺酮复合环泊酚在老年患者超声胃镜检查中的临床应用效果。方法 选取2023年10—12月首都医科大学宣武医院行无痛超声胃镜检查的老年患者80例,采用随机数字表法将患者分为艾司氯胺酮复合环泊酚组(EC组)和舒芬太尼复合环泊酚组(SC组),每组40例。EC组采用静脉注射艾司氯胺酮0.3 mg/kg及环泊酚0.3 mg/kg进行麻醉诱导,SC组采用静脉注射舒芬太尼0.1μg/kg及环泊酚0.3 mg/kg进行麻醉诱导,两组均采用持续输注环泊酚进行麻醉维持。比较两组患者一般情况、术中低血压及术中术后不良反应发生情况等。结果 80例患者中,男32例,女48例,年龄65~79岁,平均(70.1±2.8)岁。与SC组比较,EC组术中低血压(7.5%比30.0%)、心动过缓(7.5%比35.0%)、呼吸抑制发生率(2.5%比20.0%)及血管活性药物使用率(12.5%比52.5%)均较低,术后低血压发生率(5.0%比22.5%)较低,环泊酚用量[(28.3±4.9)mg比(34.9±5.0)mg]较低,差异均有统计学意义(P <0.05)。结论 小剂量艾司氯胺酮0.3 mg/kg复合环泊酚可安全有效用于老年患者行超声胃镜检查,术中及术后循环稳定,不增加不良反应。

Objectives To explore the clinical effect of low dose esketamine combined with cyclopofol in elderly patients undergoing ultrasound gastroscopy.Methods A total of 80 elderly patients who underwent painless ultrasound gastroscopy in Xuanwu Hospital,Capital Medical University from October to December 2023 were selected,and divided into esketamine combined with cyclopofol group(EC group)and sufentanil combined with cyclopofol group(SC group)by random number table method,with 40 cases in each group.The EC group was induced by intravenous esketamine 0.3 mg/kg and cypofol 0.3 mg/kg,the SC group was induced by intravenous sufentanil 0.1μg/kg and cypofol 0.3 mg/kg,and the two groups were maintained by continuous infusion of cypofol.The general condition,intraoperative hypotension and postoperative adverse reactions were compared between the two groups.Results Among the 80 patients,there were 32 males and 48 females,aged from 65 to 79 years,with an average of(70.1±2.8)years.Compared with SC group,the incidence of intraoperative hypotension(7.5%vs.30.0%),bradycardia(7.5%vs.35.0%),respiratory depression(2.5%vs.20.0%)and vasoactive drug use rate(12.5%vs.52.5%)were lower in EC group.The incidence of postoperative hypotension was lower(5.0%vs.22.5%),and the dosage of cyclopofol was lower[(28.3±4.9)mg vs.(34.9±5.0)mg],with statistical significance(P<0.05).Conclusions Low-dose esketamine 0.3 mg/kg combined with ciprofol is safe and effective for elderly patients undergoing endoscopic ultrasonography with more stable circulation in perioperative period.