摘要
目的探讨经皮穴位电刺激联合丙泊酚在无痛胃肠镜检查中的应用效果。方法105例行胃肠镜检查的患者,随机分为丙泊酚联合芬太尼组(P+F组)、丙泊酚联合经皮穴位电刺激组(P+T组)、丙泊酚联合安慰经皮穴位电刺激组(P+P组),每组35例。所有患者在胃镜检查前均由麻醉医生使用丙泊酚诱导至深度镇静状态,同时P+F组检查前静脉注射芬太尼50μg;P+T组检查前30 min时于穴位处粘贴电极并进行电刺激至检查结束;P+P组仅于穴位处粘贴电极片而不实施电刺激。收集所有患者检查过程中的疼痛反应评分、丙泊酚用量和检查后麻醉恢复时间,以及检查过程中或检查后患者的不良反应发生率,同时对患者及医生满意度进行评估。结果与P+P组相比,P+F组和P+T组患者的疼痛反应评分均显著降低(H=23.16,P<0.05)。P+F组患者低氧血症发生率与其他两组相比无显著差异(P>0.05)。P+F组患者眩晕程度以及恶心呕吐程度也明显高于其他两组(H=40.97,44.79,P<0.05)。P+F组患者的满意度显著低于P+T组和P+P组(H=21.80,P<0.05)。P+P组医生的满意度显著低于P+F组和P+T组(H=58.30,P<0.05)。结论经皮穴位电刺激联合丙泊酚可以满足较理想的胃肠镜检查的镇静要求,可抑制胃肠镜检查引起的不适,在保证患者满意度的前提下,其可以减少阿片类药物所致的检查后恶心、眩晕等不良反应。
Objective To investigate the application effect of transcutaneous electrical acupoint stimulation(TEAS)combined with propofol in painless gastrointestinal endoscopy.Methods A total of 105 patients who underwent gastrointestinal endoscopy were randomly divided into propofol+fentanyl group(P+F group),propofol+TEAS group(P+T group),and propofol+placebo-TEAS group(P+P group),with 35 patients in each group.All patients were induced to deep sedation by the anesthesiologist using propofol before gastroscopy;the patients in the P+F group were given intravenously injected fentanyl 50μg before gastroscopy,those in the P+T group received placement of electrodes at the acupoints at 30 minutes before examination and were given electrical stimulation till the end of the examination,and those in the P+P group received placement of electrodes at the acupoints alone without electrical stimulation.The patients were recorded in terms of pain score and the amount of propofol used du-ring examination,the time to recovery from anesthesia after examination,and the incidence rate of adverse reactions during or after examination,as well as the degree of satisfaction among patients and physicians.Results Compared with the P+P group,the P+F and P+T groups had a significant reduction in pain score(H=23.16,P<0.05).There was no significant difference in the incidence rate of hypoxemia between the P+F group and the other two groups(P>0.05),while the P+F group had significantly higher degrees of vertigo,nausea,and vomiting than the other two groups(H=40.97-44.79,P<0.05).Compared with the P+T and P+P groups,the P+F group had a significantly lower degree of satisfaction among the patients(H=21.80,P<0.05),and compared with the P+F and P+T groups,the P+P group had a significantly lower degree of satisfaction among the physicians(H=58.30,P<0.05).Conclusion TEAS combined with propofol can provide satisfactory sedation in gastrointestinal endoscopy and inhibit the discomfort caused by gastrointestinal endoscopy,and under the premise of ensuring the degree of satisfaction among patients,it can reduce the adverse reactions such as nausea and vertigo after examination caused by opioids.
作者
徐剑寒
谭海玲
张丽娜
袁莉
吴欣雨
周赞宫
冀翔宇
XU Jianhan;TAN Hailing;ZHANG Li′na;YUAN Li;WU Xinyu;ZHOU Zangong;JI Xiangyu(Department of Anesthesiology,The Affiliated Hospital of Qingdao University,Qingdao 266035,China)
出处
《精准医学杂志》
2024年第5期422-425,430,共5页
Journal of Precision Medicine
基金
青岛市中医药科研计划项目(2020-zyy061)。
关键词
针刺穴位
电刺激
二异丙酚
内窥镜检查
胃肠道
镇痛
Acupuncture points
Electric stimulation
Propofol
Endoscopy,gastrointestinal
Analgesia
