利多卡因对复合小剂量艾司氯胺酮时环泊酚抑制胃镜置入反应量效关系的影响

目的探讨利多卡因复合小剂量艾司氯胺酮对环泊酚抑制胃镜置入反应量效关系的影响。方法选取2023年6月至8月行无痛胃镜检查术的患者61例,采用随机数字表法分为环泊酚组(C组)和利多卡因复合环泊酚组(L组)。麻醉诱导时所有患者均静脉注射艾司氯胺酮0.3 mg/kg,C组患者静脉注射环泊酚,L组患者静脉注射利多卡因复合环泊酚。采用改良Dixon序贯法,采用Probit法计算两组患者应用环泊酚后抑制胃镜置入反应的半数有效剂量(ED50)及95%置信区间(CI)。结果C组抑制胃镜置入反应的ED50(95%CI)为0.347(0.309~0.382)mg/kg;L组抑制胃镜置入反应的ED50(95%CI)为0.328(0.272~0.372)mg/kg。L组ED50低于C组ED50。结论静脉注射利多卡因复合艾司氯胺酮0.3 mg/kg可以增加环泊酚用于无痛胃镜检查术的疗效。

Objective To investigate the effect of lidocaine compounded with a small dose of esketamine on the quantitative-effect relationship of cyclobenzaprine in inhibiting the response to gastroscopy placement.Methods Sixty-one patients who underwent painless gastroscopy from June to August 2023 were selected and divided into the cyclobenzaprine group(group C)and the lidocaine-compound-cyclobenzaprine group(group L)by using the random number table method.At the time of induction of anaesthesia all patients were injected intravenously with esketamine 0.3 mg/kg,patients in the group C were injected intravenously with cyclobenzaprine,and patients in the group L were injected intravenously with lidocaine-complexed cyclobenzaprine.A modified Dixon sequential method was used for the study,and the Probit method was used to calculate the half effective dose(ED50)and 95%confidence interval(CI)for inhibiting the response to gastroscopic placement after the application of cyclobutrazol in both groups.Results The ED50(95%CI)for inhibition of gastroscopic placement response was 0.347(0.309~0.382)mg/kg in the group C;and 0.328(0.272~0.372)mg/kg in the group L.The ED50 in the group L was lower than that in the group C.Conclusion Intravenous lidocaine compounded with esketamine 0.3 mg/kg increases the efficacy of cyclobenzaprine for painless gastroscopy procedures.