文章摘要

羟考酮与舒芬太尼复合依托咪酯用于老年患者胃镜检查的麻醉效果

作者: 1李欣, 1刘嘉运, 1王兰, 2李乾乾, 3曹哲丽, 1王春光
1 保定市第一中心医院麻醉科,河北 保定 071000
2 保定市第一中心医院重症医学科,河北 保定 071000
3 保定市第一中心医院消化内科,河北 保定 071000
通讯: 王春光 Email: wangchunguang@163.com
DOI: 10.3978/j.issn.2095-6959.2019.03.019

摘要

目的:比较羟考酮与舒芬太尼复合依托咪酯用于老年患者胃镜检查的麻醉效果。方法:选择 2017年2月至6月保定市第一中心医院于全身麻醉下行无痛胃镜检查的老年患者60例,男女不限,年龄65~77岁,体重46~63 kg,经美国麻醉医师协会(American Society of Anesthesiologists,ASA)分级为II级,患者随机被分为两组(n=30):羟考酮组(O组)和舒芬太尼组(S组)。O组静脉注射羟考酮 0.05 mg/kg,S组静脉注射舒芬太尼0.05 μg/kg,2 min后静脉注射依托咪酯0.2 mg/kg。术中出现呛咳或体动反应时,静脉追加依托咪酯0.05~0.1 mg/kg。记录诱导前(T0)、诱导后2 min(T1)、进镜后1 min(T2)、进镜后3 min(T3)各时间点的生命体征;记录整个胃镜检查过程中依托咪酯用量及发生注射痛、呛咳、体动、呼吸抑制的情况;记录苏醒时间及苏醒后头晕、恶心、呕吐的情况。结果:与S组比较,O组苏醒时间及依托咪酯用量减少,呛咳、体动发生率降低(P<0.05),T2时点平均动脉压降低(P<0.05),T2,T3时点心率降低恶心、呕吐的发生率降低,差异均有统计学意义(P<0.05)。两组注射痛、头晕及呼吸抑制的发生率差异无统计学意义(P>0.05)。结论:羟考酮 (0.05 mg/kg)复合依托咪酯可安全、有效地用于老年患者无痛胃镜检查,且效果优于舒芬太尼。
关键词: 羟考酮;依托咪酯;胃镜检查;老年患者

Anesthetic effect of oxycodone versus sufentanil combined with etomidate on painless gastroscopy in elderly patients

Authors: 1LI Xin, 1LIU Jiayun, 1WANG Lan, 2LI Qianqian, 3CAO Zheli, 1WANG Chunguang
1 Department of Anesthesiology, The First Center Hospital of Baoding, Baoding Hebei 071000, China
2 Department of Intensive Care Unit, The First Center Hospital of Baoding, Baoding Hebei 071000, China
3 Department of Gastroenterology, The First Center Hospital of Baoding, Baoding Hebei 071000, China

CorrespondingAuthor: WANG Chunguang Email: wangchunguang@163.com

DOI: 10.3978/j.issn.2095-6959.2019.03.019

Abstract

Objective: To compare the effect of oxycodone versus sufentanil combined with etomidate on painless gastroscopy in elderly patients. Methods: Sixty elderly patients underwent painless gastroscopy were included in this study in the First Center Hospital of Baoding from February 2017 to June 2017. Those patients of either sex, with American Society of Anesthesiologists physical status II, aged 65 to 77 years, weighing 46–63 kg, were divided into two groups (n=30): an oxycodone group (Group O) and a sufentanyl group (Group S). Patients were intravenously injected with oxycodone (0.05 mg/kg) in Group O and sufentanyl (0.05 μg/kg) in Group S. And then, all patients were intravenously injected with etomidate (0.2 mg/kg). When cough or movement occurred during gastroscopy, etomidate (0.05–0.1 mg/kg) was intravenously injected additionally. The MAP, HR, SpO2 and dosage of etomidate was recorded at the time points of before induction (T0), 2 minutes after induction (T1), 1 (T2) and 3 (T3) minutes after gastroscopy. The occurrence of cough, body movement, injection pain and respiratory depression, was recorded during the gastroscopy. And the waking time and the occurrence of adverse reactions, such as, dizziness, nausea and vomiting were recorded. Results: Compared with Group S, the waking time and dosage of etomidate decreased in Group O (P<0.05). Compared with Group S, the incidence of cough and body movement decreased in Group O (P<0.05). Compared with Group S, MAP and HR decreased in Group O (P<0.05). Compared with Group S, the incidence of nausea and vomiting decreased in Group O (P<0.05). For injection pain, dizziness and respiratory depression, there were no difference between the two groups (P>0.05). Conclusion: Efficacy oxycodone (0.05 mg/kg) combined with etomidate is superior to sufentanil for elderly patients with undergoing painless gastroscopy.
Keywords: oxycodone; etomidate; gastroscopy; elderly patient