摘要
〔目的〕观察艾司氯胺酮联合丙泊酚在无痛膀胱镜检查中的麻醉效果。〔方法〕选取行无痛膀胱镜检查男性患者100例,年龄22~65岁,体重53~79 kg,ASAⅠ~Ⅱ级,随机数字表法分为:丙泊酚联合舒芬太尼组(PS组)和丙泊酚联合艾司氯胺酮组(PK组),每组50例。PS组缓慢推注舒芬太尼0.1μg/kg;PK组缓慢推注艾司氯胺酮0.15 mg/kg。后给予丙泊酚1~2 mg/kg,记录两组患者各时间点心率、平均动脉压、脉搏血氧饱和度,观察检查过程中体动反应,并记录丙泊酚用量、镜检时间、苏醒时间,以及丙泊酚注射痛、呛咳、呼吸抑制(SpO_(2)<90%)、低血压和恶心呕吐发生情况。〔结果〕各时间点两组患者间心率、平均动脉压、脉搏氧饱和度在各时间点差异无统计学意义(P>0.05);两组间患者间丙泊酚用量、苏醒时间相比,差异无统计学意义(P>0.05);两组间恶心呕吐、体动及注射痛发生率相比,差异无统计学意义(P>0.05);与PK组相比,PS组呛咳、呼吸抑制及低血压发生率明显升高,差异有统计学意义(P<0.05)。〔结论〕艾司氯胺酮联合丙泊酚能够达到无痛膀胱镜检查的镇静镇痛效果,呼吸抑制、呛咳及低血压等不良反应少,值得临床推广。
[Objective]To observe the anesthetic effect of esmketamine combined with propofol in painless cystoscopy.[Methods]100 patients,aged 22〜65 years,weight 53〜79 kg,ASA physical status Ⅰ or Ⅱ,who underwent selective painless cystoscopy were randomized into 2 groups,50 patients in each group.In group PS,Sufentanil 0.1μLg/kg and propofol 1〜2 mg/kg were slowly injected intravenously;while in group PK,esketamine 0.15 mg/kg and propofol 1〜2 mg/kg were slowly injected intravenously.Record the HR,MAP and SpO_(2)of the two groups at each time point,Observe the body movement reaction during the examination,The dosage of propofol,microscopic examination time,recovery time,and the incidence of propofol injection pain,choking,respiratory depression(SpO_(2)<90%),hypotension,nausea and vomiting were recorded.[Results]There was no significant difference HR,MAP and SpO_(2)between the two groups at each time point(P>0.05),There was no significant difference in dosage of propofol andrecovery time between the two groups(P>0.05),There was no significant difference in the nausea and vomiting,incidence of body movement and injection pain between the two groups(P>0.05),Compared with PK group,the incidence of respiratory depression,choking and hypotension in PS group was significantly higher(P<0.05).[Conclusion]Esketamine combined with propofol can achieve the sedative and analgesic effect of painless cystoscopy,with less adverse reactions such as respiratory depression,choking and hypotension,which is worthy of clinical promotion.
作者
向导
马传根
侯婷婷
于沙双
信文启
李爱香
张义轩
XIANG Dao;MA Chuangen;HOU Tingting;YU Shashuang;XIN Wenqi;LI Aixiang;ZHANG Yixuan(Department of Anesthesiology,Huaihe Hospital of Henan University,Kaifeng 475000,China)
出处
《河南大学学报（医学版）》
CAS
2021年第6期415-418,共4页
Journal of Henan University:Medical Science
基金
河南省医学科技攻关计划(201404029)
开封市科技攻关计划(2003017)。
