实用肝脏病杂志2024，Vol.27Issue(2)：230-233,4.DOI:10.3969/j.issn.1672-5069.2024.02.018
内镜下硬化剂治疗乙型肝炎肝硬化并发食管胃底静脉曲张破裂出血患者应用不同剂量羟考酮联合丙泊酚靶控输注麻醉效果研究
Anesthesia of different concentrations of oxycodone and target-controlled infusion of propofol combination in patients with hepatitis B liver cirrhosis and esophageal variceal bleeding undergoing endoscopic sclerotherapy
摘要
Abstract
Objective The aim of this study was to explore the anesthesia of different concentrations of oxycodone and target-controlled infusion of propofol combination in patients with hepatitis B liver cirrhosis(LC)and esophageal variceal bleeding(EVB)undergoing endoscopic sclerotherapy(EIS).Methods 87 patients with hepatitis B viral infection-induced LC and EVB were enrolled in our hospital between May 2021 and March 2023,and all patients underwent EIS.The patients were randomly divided into group A,B and C,receiving oxycodone at doses of 0.04 mg·kg-1,0.08 mg·kg-1 and 0.12 mg·kg-1 for induction of anesthesia,and the combination of target-controlled infusion of propofol was continued.The parameters at immediately after disappearance of eyelash reflection(T1),at 1 min after endoscope placement(T2)and immediately after endoscope removal(T3)were recorded.The postoperative recovery quality and pain were evaluated by Stward's scores and the visual analogue scale(VAS).Serum interleukin(IL-6)and tumor necrosis factor α(TNF-α)levels were detected by ELISA.Results At T1,T2 and T3,the effect compartment concentrations of propofol in group C were(3.0±0.2)μg/mL,(3.5±0.2)μg/mL and(3.1±0.6)μg/mL,all much lower than[(3.2±0.3)μg/mL,(3.7±0.2)μg/mL and(3.5±0.5)μg/mL,P＜0.05]in group B or[(3.5±0.4)μg/mL,(3.9±0.3)μg/mL and(3.8±0.4)μg/mL,P＜0.05]in group A;the dosage of propofol,the awakening time and the Stward's socre in group C(388.3±27.1)mg,(11.8±2.0)min and(4.0±0.9),significantly different as compared to[(420.6±31.5)mg,(9.1±1.3)min and(5.1±0.8),P＜0.05]in group B or[(458.7±28.7)mg,(8.3±1.6)min and(4.0±0.9),P＜0.05]in group A;at 1 hour and 2 hours after EIS,the VAS scores in group C or group B were much lower than in group A(P＜0.05);at6 hours after operation,serum IL-6 and TNF-α levels in group B were(30.5±4.4)pg/mL and(16.3±1.9)pg/mL,both much lower than[(37.3±5.6)pg/mL and(20.6±2.4)pg/mL,P＜0.05]in group A or[(35.9±4.7)pg/mL and(19.1±2.6)pg/mL,P＜0.05]in group C;the incidences of nausea and vomiting,and respiratory depression in group C were27.6%and20.7%,much higher than 10.3%and 3.5%in group A(P＜0.05)or 3.5%and 0.0%in group B(P＜0.05).Conclusion We recommend oxycodone at dose of 0.08 mg·kg-1 for induction of anesthesia,and target-controlled infusion of propofol in patients with EVB during EIS,which might guarantee an relatively good anesthetic effect,and less complications.关键词
肝硬化/食管胃底静脉曲张破裂出血/内镜下硬化剂治疗/丙泊酚/羟考酮/麻醉Key words
Liver cirrhosis/Esophageal variceal bleeding/Endoscopic sclerotherapy/Propofol/Oxycodone/Anesthesia引用本文复制引用
王红霞,胥晓倩,于明帅..内镜下硬化剂治疗乙型肝炎肝硬化并发食管胃底静脉曲张破裂出血患者应用不同剂量羟考酮联合丙泊酚靶控输注麻醉效果研究[J].实用肝脏病杂志,2024,27(2):230-233,4.基金项目
成都市科技局医学科研项目(编号:19PJ210) （编号:19PJ210）
