摘要
目的:评价艾司氯胺酮复合丙泊酚用于胃镜检查的安全性并筛选出艾司氯胺酮的适宜剂量.方法:选择期间行胃镜检查的患者,年龄为18~80岁,美国麻醉医师协会(ASA)分级为Ⅰ~Ⅱ级,性别不限,体重指数(BMI)为18~25 kg·m^(-2).随机分为3组,A组为0.3 mg·kg^(-1)艾司氯胺酮组,B组为0.5 mg·kg^(-1)艾司氯胺酮组,C组为空白对照组,给予相应剂量的生理盐水,各组静脉注射艾司氯胺酮30 s后,再给予丙泊酚,待受检者睫毛反射消失时置入胃镜.记录关键时间点生命体征、丙泊酚用量、苏醒时间、术后视觉模拟评分法(VAS)评分、不良反应发生情况等.结果:对照组给予丙泊酚后平均动脉压(MAP)较基础值明显降低(P<0.05),B组给予艾司氯胺酮后心率(HR)、MAP较基础值有明显提升(P<0.05),A组血流动力学更加平稳;A组与B组丙泊酚用量明显低于对照组(P<0.05);B组苏醒时间明显延长,较其他2组均有统计学差异(P<0.05),A组较C组无明显差异;3组不良反应情况比较均无统计学差异(P>0.05).结论:在接受无痛胃镜检查的患者中,诱导前单次静脉给予0.3 mg·kg^(-1)的艾司氯胺酮是安全有效的,苏醒时间短、不良反应少、能有效节省丙泊酚用量,值得临床推广应用.
Objective:Evaluate the safety of esketamine combined with propofol in gastroscopy and select the appropriate dose of esketamine.Methods:Patients scheduled for elective gastroscopy were enrolled into the study,aged between 18 and 80 years,with an American Society of Anesthesiologists(ASA)physical statusⅠ~Ⅱ,regardless of gender,and a body mass index(BMI)of 18~25 kg·m^(-2).All patients were randomly divided into three groups,Group A was 0.3 mg·kg^(-1)esketamine group,group B was 0.5 mg·kg^(-1)esketamine group,and group C was blank control group.The corresponding dose of normal saline was given to each group.Propofol was given after intravenous injection of esketamine for 30 s,and gastroscope was inserted when eyelash reflex disappeared.Vital signs,dosage of propofol,recovery time,postoperative VAS score and adverse effects were recorded.Results:Mean arterial pressure(MAP)was significantly lower than the base value after administration of esketamine in the control group.Heart rate(HR)and MAP of the group B were significantly increased compared with the base value after esketamine(P<0.05),and the hemodynamics of group A was more stable.The dosages of propofol in group A and group B were significantly lower than the control group(P<0.05).The recovery time of group B was significantly longer than that of the other two groups(P<0.05),and there was no significant difference between group A and group C.There was no significant difference in adverse effects among the three groups(P>0.05).Conclusion:Esketamine administration as a single dose of 0.3 mg·kg^(-1)before induction of propofol is safe and effective,with short awakening time and few adverse effects,and can effectively save the dosage of propofol,which is worthy of clinical promotion and application.
作者
李春林
沈阳
许亚菲
张忠其
LI Chun-lin;SHEN Yang;XU Ya-fei;ZHANG Zhong-qi(Department of Anesthesiology,Xingtan Hospital Affiliated to Shunde Hospital of Southern Medical University,Foshan 52S325,China;Department of Anesthesiology,Affiliated Shunde Hospital to Jinan University,Foshan 528305,China)
出处
《中国新药杂志》
CAS
CSCD
北大核心
2022年第8期773-777,共5页
Chinese Journal of New Drugs
基金
广东省医院药学研究基金资助项目(新晨舒适化医疗专项基金资助项目,2020XC14)
佛山市卫生健康局医学科研项目(20220274)。
