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目的:探讨艾司氯胺酮在老年患者行无痛胃肠镜检查中的麻醉效果。方法:选择2022年1月—2023年1月于宜昌市中心人民医院行无痛胃肠镜检查的老年患者120例,采用随机数字表法分为观察组(n=60)和对照组(n=60)。对照组患者采用丙泊酚,观察组采用丙泊酚联合艾司氯胺酮。比较两组患者的麻醉效果。结果:与对照组相比,观察组的麻醉起效时间明显缩短[(15.12±2.54) s vs (25.86±3.17) s],丙泊酚用量减少[(168.65±31.63) mg vs (221.31±41.78) mg];观察组患者的苏醒时间缩短、苏醒质量评分及满意度评分更高、苏醒即刻及苏醒后30 min视觉模拟量表评分更低(均P<0.05)。在血流动力学方面,观察组患者胃镜置入后心率(T2)、血氧饱和度、脑电双频谱指数较对照组均明显升高(均P<0.05)。与对照组相比,观察组操作结束即刻(T5)血糖、皮质醇、肾上腺素均明显降低,且总不良反应显著减少(26.67%vs 58.33%)(均P<0.05)。结论:艾司氯胺酮应用于老年患者无痛胃肠镜检查中可有效缩短麻醉起效时间和苏醒时间,减少丙泊酚用量,减轻应激反应和疼痛程度,稳定血流动力学,降低不良反应发生率,提升患者苏醒质量和满意度。
Abstract：Objective: To explore the anesthetic effect of esketamine in elderly patients undergoing painless gastrointestinal endoscopy. Methods: A total of 120 elderly patients who underwent painless gastrointestinal endoscopy at Yichang Central People's Hospital from January 2022 to January 2023 were selected and divided into the observation group(n=60) and the control group(n=60) using a random number table method. Patients in the control group were given propofol, while those in the observation group were given propofol combined with esketamine. The anesthetic effects of the two groups were compared. Results: Compared with the control group, the onset time of anesthesia in the observation group was significantly shortened [(15.12±2.54) s vs(25.86±3.17) s], and the dosage of propofol was reduced [(168.65±31.63) mg vs(221.31±41.78) mg]. The awakening time of patients in the observation group was shortened, the awakening quality score and satisfaction score were higher, and the visual analog scale scores immediately after awakening and 30 minutes after awakening were lower(all P<0.05). In terms of hemodynamics, after the endoscope insertion(T2), the heart rate, blood oxygen saturation, and bispectral index of patients in the observation group were significantly higher than those in the control group(all P<0.05). Compared with the control group, the blood glucose, cortisol, and adrenaline at the end of the procedure(T5) in the observation group were significantly lower, and the total incidence of adverse reactions was significantly reduced(26.67% vs 58.33%)(all P<0.05). Conclusion: The application of esketamine in painless gastrointestinal endoscopy elderly patients underwent can effectively shorten the onset and recovery time of anesthesia, reduce the dosage of propofol, alleviate stress responses and pain levels, stabilize hemodynamics, reduce the incidence of adverse reactions, and improve the quality of awakening and patient satisfaction.
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基本信息:
中图分类号:R614
引用信息:
[1]陶虓嫣,刘怡菲,程传喜,等.艾司氯胺酮在老年患者行无痛胃肠镜检查中的麻醉效果分析[J].巴楚医学,2025,8(03):61-66.
基金信息:
湖北省自然科学基金项目(2022CFC044); 宜昌市医疗卫生研究项目(A23-1-030)
2025-09-28
2025-09-28