无痛胃镜检查中年龄对丙泊酚用量的影响分析

Analysis of the impact of patients ages on propofol dosage in painless gastroscopy

摘要:

目的 分析无痛胃镜检查中年龄对丙泊酚用量的影响。方法 回顾性分析2017年1月－2020年6月该院收治的158例无痛胃镜检查患者的临床资料，依据患者年龄，将其分为青年组（18～44岁，n = 57）、中年组（45～59岁，n = 51）和老年组（ ≥ 60岁，n = 50），比较3组患者麻醉情况和安全性。结果 青年组意识消失时，丙泊酚用量和丙泊酚总用量多于中年组和老年组，且中年组多于老年组；青年组平均动脉压（MAP）、心率（HR）、呼吸频率（RR）、经皮动脉血氧饱和度（SpO₂）水平高于中年组和老年组，且中年组高于老年组；青年组麻醉起效时间、麻醉恢复时间、定向力恢复时间和离室时间短于中年组和老年组，且中年组短于老年组；老年组气道梗阻发生率、低氧血症发生率、托下颌发生率、面罩通气发生率、心血管不良事件总发生率、镇静相关不良事件总发生率和进镜受阻发生率高于青年组和中年组，进镜顺利发生率低于青年组和中年组，差异均有统计学意义（P < 0.05）。结论 年龄增长可能会增加无痛胃镜检查中患者的丙泊酚用量，延长麻醉起效时间、麻醉恢复时间、定向力恢复时间和离室时间，增加应激反应和不良反应，临床中对于高龄患者，应当加强监测。

Abstract:

Objective To analyze the impact of patients ages on propofol dosage in painless gastroscopy.Methods A retrospective analysis was conducted on the clinical data of 158 painless gastroscopy patients from January 2017 to June 2020. They were divided into the young group (18 ~ 44 years old, n = 57), the middle-aged group (45 ~ 59 years old, n = 51), and the elderly group ( ≥ 60 years old, n = 50) based on their age. The anesthesia status and safety of each group were compared.Results The results showed that the dosage of propofol, average total dosage of propofol, MAP, HR, RR, SpO₂ levels in the young group were higher than those in the middle-aged and elderly groups when consciousness disappeared, and the middle-aged group was higher than the elderly group; The onset time, anesthesia recovery time, orientation recovery time, and departure time in the young group of patients were shorter than those in the middle-aged and elderly groups, and the middle-aged group was shorter than the elderly group (P < 0.05). The incidence of airway obstruction, hypoxemia, mandible support, mask ventilation, adverse cardiovascular events, sedation related adverse events, and incidence of obstructed endoscopy in the elderly group were higher than those in the young and middle-aged groups. The incidence of smooth endoscopy was lower than that in the young and middle-aged groups (P < 0.05).Conclusion Aging may increase the dosage of propofol in patients underwent painless gastroscopy under anesthesia, prolong the onset time, anesthesia recovery time, orientation recovery time, and departure time, increase stress reactions and adverse reactions, and strengthen monitoring for elderly patients in clinical practice.