目的 比较环泊酚和丙泊酚在经口气管插管小肠镜麻醉中对血流动力学及术后不良事件的影响。方法 选取2023-12至2024-09在空军特色医学中心手术室接受全身麻醉小肠镜检查的患者180例,随机分为环泊酚组(C组)和丙泊酚组(P组),每组各90例。C组在麻醉诱导和维持阶段均使用环泊酚,而P组则使用丙泊酚维持镇静。比较两组麻醉诱导前(T0)、麻醉诱导后2 min(T1)、小肠镜进镜时(T2)、麻醉给药后30 min(T3)、手术结束时(T4)、拔管时(T5)的血流动力学指标、术中血管活性药物的使用情况、麻醉相关不良事件、苏醒时间以及拔管时间等关键指标。结果 在T1和T2时间点,C组的收缩压和舒张压均高于P组(P<0.05),C组低血压的发生率和总次数均低于P组(P<0.05),且C组在血管活性药物使用次数和用量上也显著低于P组(P<0.05)。C组患者注射痛、恶心、呕吐和腹胀的发生均显著低于P组(P<0.05)。C组患者的苏醒时间和拔管时间长于P组(P<0.01)。结论 相较于丙泊酚,环泊酚麻醉在无痛小肠镜检查术中能更有效地维持血流动力学稳定,并降低术后胃肠道不良反应的发生。
Abstract
Objective To compare the effects of ciprofol and propofol on hemodynamics and postoperative adverse events during oral catheterization and enteroscopy. Methods A total of 180 patients who underwent endotracheal intubation and enteroscopy under general anesthesia at Characteristics Medical Center of PLA Air Force from December 2023 to September 2024 were enrolled in this study and randomly divided into ciprofol group (group C) and propofol group (group P), with 90 cases in each group. Group C received ciprofol during induction and maintenances, while group P received propofol to maintain sedation. This study recorded the hemodynamic indexes before anesthesia induction (T0), 2min after anesthesia induction (T1), at enteroscopy entry (T2), 30min after anesthesia administration (T3), at the end of surgery (T4), and at extubation (T5), the use of vasoactive drugs during surgery, anesthesia related adverse events, recovery time, extubation time and other key indicators. Results At T1 and T2 time points, the systolic blood pressure and diastolic blood pressure in group C were higher than those in group P (P<0.05), the incidence and total times and total times of hypotension in group C were lower than those in group P (P<0.05), and the times and dosage of vasoactive drugs in group C were also significantly lower than those in group P (P<0.05). The incidence of injection pain, nausea, vomiting, and abdominal distension in group C was significantly lower than in group P (P<0.05). The recovery time and extubation time for group C were longer than those in group P (P<0.001). Conclusions Compared with propofol, ciprofol anesthesia can maintain hemodynamic stability more effectively and reduce the incidence of postoperative gastrointestinal adverse reactions during painless enteroscopy.
关键词
无痛小肠镜 /
环泊酚 /
丙泊酚 /
全麻诱导 /
全麻维持
Key words
painless enteroscopy /
ciprofol /
propofol /
general anesthesia induction /
general anesthesia maintenance
{{custom_sec.title}}
{{custom_sec.title}}
{{custom_sec.content}}
参考文献
[1] 刘 红,吉锦泉,于冬男,等.地佐辛复合丙泊酚对无痛小肠镜检查患者血流动力学及麻醉深度的影响[J].中华实用诊断与治疗杂志,2013,27(11):1061-1063.
[2] 刘 聪.无痛小肠镜与普通小肠镜检查的临床对比研究[J].世界复合医学,2021,7(2):21-24.
[3] 胡颖婷,许 辉,郑晓静, 等.目标导向液体治疗对改善腹腔镜妇科手术患者术后早期恢复质量的效果[J]. 江苏医药, 2024, 50 (6): 568-572,576.
[4] 田可耘,吉锦泉,王志鹏,等.小剂量右美托咪定复合丙泊酚在无痛小肠镜检查中的临床效果及安全性[J].热带医学杂志,2014,14(3):318-320.
[5] 邝立挺,张 涛,陈坚伟,等.地佐辛复合丙泊酚在双气囊小肠镜检查中的临床应用研究[J].医学理论与实践,2013,26(12):1558-1559,1562.
[6] 杜晓媛,杨峻岭,郝在军. 环泊酚在全身麻醉中应用的研究进展[J]. 实用药物与临床, 2024, 27 (12): 943-946.
[7] 张俊伟,胡艳辉,李之明.环泊酚在无痛胃肠镜麻醉中的应用研究[J].中国现代药物应用,2022, 16(16):35-38.
[8] 易强林,莫怀忠,胡 慧,等.环泊酚与丙泊酚在老年患者无痛胃镜检查中的比较[J].临床麻醉学杂志,2022,38(7):712-715.
[9] 冯炎超,任学军.环泊酚与丙泊酚对胸腔镜下肺癌根治术患者术后疲劳影响的比较研究[J].医药论坛杂志,2024,45(15):1651-1657.
[10] 谷晶晶,刘珊珊,吴冬良,等.环泊酚与丙泊酚麻醉在老年腹腔镜胆囊切除术中的应用效果比较[J].中国民康医学,2024,36(15):159-162.
[11] Liang P, Dai M, Wang X, et al. Efficacy and safety of ciprofol vs. propofol for the induction and maintenance of general anaesthesia: a multicentre, single-blind, randomised, parallel-group, phase 3 clinical trial[J]. Eur J Anaesthesiol, 2023,40(6):399-406.
[12] 王金花,张玉涛,高春梅.无痛胃肠镜在消化内科临床中的应用研究[J].饮食保健,2020,7(1): 56-57.
[13] Ortegal G H, Barbosa E C, Faria P C, et al. Ciprofol versus propofol for adult sedation in gastrointestinal endoscopic procedures: a systematic review and meta-analysis[J]. Minerva Anestesiol, 2024,90(11):1013-1021.
[14] Stogiannou D, Protopapas Adonis, Protopapas Andreas, et al. Is propofol the optimal sedative in gastrointestinal endoscopy?[J]. Acta gastro-enterologica Belgica, 2018, 81(4):520-524.
[15] Zhao S B, Deng B, Chen B Q, et al. Effect of quantitative consciousness index on seizure parameters during electroconvulsive therapy in patients with major depressive disorder.[J].World J Psychiatry,2024,14(9):1375-1385.
[16] 甘 川,彭伟龙,黄静翔,等.环泊酚与丙泊酚麻醉维持在老年腹腔镜结直肠癌根治术患者中的应用比较[J].广东医学, 2024, 45 (6): 706-711.
[17] Sirvinskas E, Kinderyte A, Trumbeckaite S, et al. Effects of sevoflurane vs. propofol on mitochondrial functional activity after ischemia-reperfusion injury and the influence on clinical parameters in patients undergoing CABG surgery with cardiopulmonary bypass[J]. Perfusion,2015,30(7):590-595.
[18] 蔡孟杰,刘先保,王寿平.环泊酚的应用现状与研究进展[J]. 广东医学, 2024, 45 (6): 789-793.
[19] Liao J,Li M,Huang C,et al.Pharmacodynamics and pharmacokinetics of HSK3486,a Novel 2,6-Disubstituted phenol derivative as a general anesthetic[J].Front Pharmacol, 2022,13: 830791.
[20] 回宇峰,谭思琪,孙莹杰.环泊酚联合阿芬太尼用于支气管镜检查术患者的临床研究[J]. 中国临床药理学杂志, 2024, 40 (19): 2806-2810.
[21] 王 丹,殷 飞,孙 杨,等.环泊酚对老年患者胸腔镜肺癌根治术中血流动力学和术后苏醒质量的影响[J].中国现代医学杂志,2024,34(2):18-22.
PDF(926 KB)
