依托咪酯-丙泊酚混合液麻醉用于无痛胃肠镜检查术的临床效果

Application of etomidate-propofol mixture anaesthesia in painless gastrointestinal endoscopy

摘要:

目的 探讨依托咪酯-丙泊酚混合液麻醉用于无痛胃肠镜检查术的临床效果。方法 选取2023年9月－2023年11月于该院行无痛胃肠镜检查的患者82例，采用随机数表法分成依托咪酯-丙泊酚混合液组（观察组，n = 41）和丙泊酚组（对照组，n = 41）。记录两组患者检查前30 min和离恢复室前吗啡-苯丙胺评分量表（MBG），记录两组患者麻醉诱导前（T₀）、进镜前（T₁）、麻醉诱导后5 min（T₂）和唤醒时（T₃）的心率（HR）、平均动脉压（MAP）和经皮动脉血氧饱和度（SpO₂），记录两组患者苏醒时间、恢复室停留时间、丙泊酚总用量、胃肠镜检查时间和不良反应发生情况。结果 两组患者离恢复室前MBG评分较检查前30 min明显升高，但观察组离恢复室前MBG评分低于对照组，差异均有统计学意义（P < 0.05）。T₁、T₂和T₃时点，观察组MAP、HR和SpO₂高于对照组，差异均有统计学意义（P < 0.05）。观察组苏醒时间和恢复室停留时间短于对照组，差异均有统计学意义（P < 0.05）。观察组丙泊酚总用量少于对照组，差异有统计学意义（P < 0.05）。观察组低血压、低氧血症和注射痛发生率低于对照组，差异均有统计学意义（P < 0.05），两组患者其他不良反应发生率比较，差异无统计学意义（P > 0.05）。结论 依托咪酯-丙泊酚混合液麻醉，可以降低无痛胃肠镜检查术后MBG评分，有助于降低丙泊酚潜在成瘾和滥用的风险，而且可以使循环和呼吸功能更稳定，不良反应发生率更低，同时可缩短苏醒时间和恢复室停留时间，值得临床推广应用。

Abstract:

Objective To explore the effect of etomidate-propofol mixture anaesthesia in painless gastrointestinal endoscopy.Methods Eighty-two patients who underwent painless gastrointestinal endoscopy from September 2023 to November 2023 were divided into etomidate-propofol mixture group (observation group, n = 41) and propofol group (control group, n = 41) by using the random number table method. Morphine-benzedrine group (MBG) scores were recorded 30 min before the examination and before leaving the recovery room in both groups. Percutaneous arterial oxygen saturation (SpO₂) , heart rate (HR) and mean arterial pressure (MAP) were noted at anesthesia induction (T₀), before entering the endoscope (T₁), 5 min after anesthesia induction (T₂), and awakening (T₃). Gastrointestinal endoscopy time, awakening time, recovery room stay time, total propofol consumption, and adverse reactions were also documented.Results MBG scores in both groups significantly increased before leaving the recovery room compared to 30 min before the examination, the observation group had lower MBG scores before leaving the recovery room in comparison with the control group, there were statistically significant (P < 0.05). From T₁ to T₃, MAP, SpO₂, HR were higher in the observation group than those in the control group, there were statistically significant (P < 0.05). The observation group had shorter awakening time and recovery room stay time, there were statistically significant (P < 0.05). The observation group had lower total propofol consumption, there was statistically significant (P < 0.05). The observation group also exhibited a lower incidence of hypotension, hypoxemia, and injection pain, there were statistically significant (P < 0.05), with no statistically significant difference in the incidence of other adverse reactions (P > 0.05).Conclusion Etomidate-propofol combination anesthesia can reduce postoperative MBG scores in painless gastrointestinal endoscopy, contributing to a decreased risk of potential propofol addiction and abuse. Additionally, it stabilizes circulatory and respiratory functions, reduces adverse reactions rate, and shortens awakening time and recovery room stay time. Its application is worthy of further promotion.