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| 奥赛利定或舒芬太尼在无痛胃镜检查中的应用效果 |
| Efficiency of the application of oliceridine or sufentanil in painless gastroscopy |
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| DOI：10.12089/jca.2024.12.005 |
| 中文关键词: 奥赛利定 舒芬太尼 丙泊酚 无痛胃镜 呼吸抑制 |
| 英文关键词: Oliceridine Sufentanil Propofol Painless gastroscopy Respiratory depression |
| 基金项目:国家临床重点专科建设项目（ywb0007） |
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| 中文摘要: |
目的：比较奥赛利定或舒芬太尼分别联合丙泊酚在无痛胃镜检查中的应用效果。
方法：选择行无痛胃镜检查患者144例，男80例，女64例，年龄20～64岁，BMI 18.5～28.0 kg/m 2，ASA Ⅰ或Ⅱ级。采用随机数字表法分为两组：奥赛利定组（O组）和舒芬太尼组（S组），每组72例。O组采用奥赛利定0.02 mg/kg、丙泊酚1.5 mg/kg， S组采用舒芬太尼0.1 μg/kg、丙泊酚1.5 mg/kg进行麻醉诱导。记录麻醉诱导前、诱导完成后、胃镜置入时、胃镜置入后3 min和胃镜拔除时的HR、MAP、SpO2。记录麻醉起效时间、检查时间、苏醒时间、离室时间、丙泊酚追加次数、丙泊酚用量、苏醒和出室时VAS疼痛评分。记录检查期间呼吸相关不良事件、低血压、心动过缓、心动过速、体动和呛咳等不良反应发生情况，术后24 h电话随访恶心呕吐、腹痛不适、疲劳等不良事件发生情况和患者满意度。
结果：与S组比较，O组诱导完成后SpO2明显增高，胃镜置入时HR明显减慢，离室时间明显缩短，亚临床呼吸抑制、恶心呕吐发生率明显降低，患者满意度评分明显增高（P<0.05）。两组麻醉起效时间、检查时间、苏醒时间、丙泊酚追加次数、丙泊酚用量、苏醒和出室时VAS疼痛评分，检查期间低血压、心动过缓、心动过速、体动和呛咳发生率，术后随访腹痛不适和疲劳发生率差异均无统计学意义。
结论：与舒芬太尼比较，奥赛利定联合丙泊酚用于无痛胃镜检查血流动力学稳定，恢复室停留时间缩短，呼吸相关不良事件及恶心呕吐发生率降低，患者满意度提高，是无痛胃镜诊疗中安全、有效的麻醉方案。 |
| 英文摘要: |
Objective: To compare the application effects of oliceridine or sufentanil combined with propofol respectively in painless gastrointestinal endoscopy.
Methods: A total of 144 patients, 80 males and 64 females, aged 20-64 years, BMI 18.5-28.0 kg/m 2, ASA physical status Ⅰ or Ⅱ, underwent painless gastrointestinal endoscopy. They were randomly divided into two groups by the random number table method: the oliceridine group (group O) and the sufentanil group (group S), 72 patients in each group. Group O was induced with oliceridine at 0.02 mg/kg and propofol at 1.5 mg/kg, while group S was induced with sufentanil at 0.1 μg/kg and propofol at 1.5 mg/kg. HR, MAP, and SpO2 at specific time points: before anesthesia induction, after induction completion, during gastroscope insertion, 3 minutes after gastroscope insertion, and upon removal of the gastroscope were recorded. Additionally, record the onset time of anesthesia, examination time, wake-up time, time to discharge from the recovery room, additional times of propofol, total propofol dosage, and pain scores at the time of awakening and leaving the room. Record the adverse reactions including respiratory-related adverse events, hypotension, bradycardia, tachycardia, body movement, coughing during the examination. Conduct a telephone follow-up 24 hours after the operation to record the incidence of abdominal discomfort, nausea and vomiting, fatigue, and patient satisfaction.
Results: Compared with group S, in group O, SpO2 significantly increased after anesthesia induction, HR significantly slowed down when the gastroscope was inserted, the time to discharge from the recovery room was significantly shortened, the incidences of subclinical respiratory depression, nausea and vomiting were significantly reduced, and the patient satisfaction score was significantly increased (P < 0.05). There were no statistically significant differences between the two groups in anesthesia onset time, examination time, wake-up time, additional times of propofol, total propofol dosage, VAS pain scores at awakening and leaving the room, and the incidences of hypotension, bradycardia, tachycardia, body movement and cough during the examination, as well as the incidences of abdominal discomfort and fatigue during postoperative follow-up.
Conclusion: Compared with sufentanil, the combination of oliceridine and propofol for painless gastroscopy shows more stable hemodynamics, shorter stay in the recovery room, lower incidence of respiratory-related adverse events and nausea and vomiting, and higher patient satisfaction. It is a safe and effective anesthesia scheme for painless gastroscopy diagnosis and treatment. |
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