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| 不同剂量环泊酚用于无痛胃镜检查的效果 |
| Effect of different doses of ciprofol in painless gastroscopy |
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| DOI：10.12089/jca.2023.05.006 |
| 中文关键词: 环泊酚 丙泊酚 胃镜检查 镇静 |
| 英文关键词: Ciprofol Propofol Gastroscopy Sedation |
| 基金项目:南京医科大学科技发展基金（NMUB20210347） |
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| 摘要点击次数: 1160 |
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| 中文摘要: |
目的 比较不同剂量环泊酚应用于无痛胃镜检查的效果。
方法 选择择期行无痛胃镜检查患者160例，男78例，女82例，年龄18～64岁，BMI 18～30 kg/m2，ASA Ⅰ或Ⅱ级。采用随机数字表法将患者分为四组：环泊酚0.4 mg/kg组（C1组，n=40）、环泊酚0.5 mg/kg组（C2组，n=40）、环泊酚0.6 mg/kg组（C3组，n=40）和丙泊酚2 mg/kg组（P组，n=39）。C1组、C2组和C3组分别静脉注射环泊酚0.4、0.5、0.6 mg/kg，P组则静脉注射丙泊酚2 mg/kg。若检查过程中发生呛咳或体动，C1组、C2组和C3组追加环泊酚0.1 mg/kg，P组追加丙泊酚0.5 mg/kg。10 min内追加次数≤1次，则为镇静成功。记录镇静成功例数、环泊酚或丙泊酚追加例数、胃镜检查时间、苏醒时间和离院时间。记录麻醉前即刻（T0）、进镜前即刻（T1）、内镜到达十二指肠降部时（T2）、内镜退出咽腔时（T3）的HR、SBP、DBP、SpO2。记录检查过程中呛咳、体动、注射痛和低氧血症（SpO2＜90%）等不良反应的发生情况。
结果 与C1组比较，C2组、C3组和P组镇静成功率明显升高（P＜0.05）。与C2组比较，C1组环泊酚追加比例明显升高，C3组环泊酚追加比例明显降低（P＜0.05）。与T0比较，T1、T2时四组HR明显减慢，SBP和DBP明显降低，C3组SpO2明显降低（P＜0.05）。与C3组比较，T1、T2时C1组、C2组和P组SpO2明显升高（P＜0.05）。与C1组比较，C2组、C3组和P组的呛咳、体动发生率明显降低，P组注射痛发生率明显升高（P＜0.05）。与C3组比较，C1组和C2组的低氧血症发生率明显降低（P＜0.05）。
结论 静脉注射环泊酚0.5 mg/kg镇静成功率高，呼吸抑制及注射痛发生率低，可安全有效地应用于胃镜检查。 |
| 英文摘要: |
Objective To compare the effect of different doses of ciprofol in painless gastroscopy.
Methods A total of 160 patients underwent elective painless gastroscopy, including 78 males and 82 females, aged 18-64 years, BMI 18-30 kg/m2, ASA physical status Ⅰ or Ⅱ, who were divided into four groups by random number table method: ciprofol 0.4 mg/kg group (group C1, n = 40), ciprofol 0.5 mg/kg group (group C2, n = 40), ciprofol 0.6 mg/kg group (group C3, n = 40) and propofol 2 mg/kg group (group P, n = 39). Groups C1, C2, and C3 were injected with ciprofol 0.4 mg/kg, 0.5 mg/kg, and 0.6 mg/kg respectively, and group P was injected with propofol 2 mg/kg. In case of cough or body movement during gastroscopy, ciprofol 0.1 mg/kg were injected in groups C1, C2, and C3, and propofol 0.5 mg/kg was injected in group P. The sedation was successful if the number of additions within 10 minutes was less than or equal to one time. The number of successful sedation cases, the number of additional cases of cyclopofol or propofol, the time of gastroscopy, recovery time and discharge time were recorded. The HR, SBP, DBP, and SpO2 of the patients were recorded immediately before anesthesia (T0), immediately before entering the endoscope (T1), when the endoscope reached the descending duodenum (T2), when the endoscope exited the pharyngeal cavity (T3). The occurrence of adverse reactions such as coughing, body movement, injection pain and hypoxemia (SpO2 < 90%) were also recorded.
Results Compared with group C1, the success rate of sedation in groups C2, C3, and P were significantly higher (P < 0.05). Compared with group C2, and the rate of ciprofol addition in group C1 were significantly increased the rate of ciprofol addition in group C3 were significantly decreased (P < 0.05). Compared with T0, HR at T1 and T2 in all groups were significantly slowed down, SBP and DBP were significantly decreased, and SpO2 in group C3 was significantly decreased (P < 0.05). Compared with group C3, SpO2 were significantly increased in groups C1, C2, and P at T1 and T2 (P < 0.05). Compared with group C1, the incidence of choking and body movement in groups C2, C3, and P were significantly decreased, and the incidence of injection pain in group P was significantly increased (P < 0.05). Compared with group C3, the incidence of hypoxemia in groups C1 and C2 were significantly decreased (P < 0.05).
Conclusion Intravenous injection of ciprofol 0.5 mg/kg is highly sedative success, and the incidence of respiratory depression and injection pain is low, therefore it can be safely and effectively used in gastroscopy. |
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