艾司氯胺酮复合环泊酚在老年患者结肠镜检查去阿片化麻醉中的应用OACSTPCD

Objective To observe the effect of opioid-free anesthesia with esketamine and ciprofol for the elderly underwent colonoscopy.Methods 160 elderly patients underwent colonoscopy were included in this study.Those patients were assigned to esketamine combined with ciprofol group(group E,n = 80)and sufentanil combined with ciprofol(group S,n = 80).Patients were intravenously injected respectively with esketamine 0.2 mg/kg in group E and sufentanil 0.1 μg/kg in group S.Then,all the patients were intravenously injected with ciprofol(0.2 mg/kg).Mean arterial pressure(MAP),heart rate(HR)and percutaneous arterial oxygen saturation(SpO2)were recorded before injection of test drug(T0),when modified observer's assessment of alertness/sedation(MOAA/S)score was 0 points(T1),when colonoscopy through hepatic flexure(T2)and colonoscopy was removed after examination(T3).The induction time of anesthesia,time of fully awake,rate of successful anesthesia,additional dose of ciprofol,satisfaction score and incidence of adverse events were recorded.Results Compared with T0,MAP at T1,T2 and T3 in two groups was decreased,HR at T1 in group E,HR at T1,T2 and T3 in group S and SpO2 at T1 and T2 in group S were decreased,the differences were statistically significant(P<0.05).Compared with T1,MAP and HR at T2 in two groups were increased,the differences were statistically significant(P<0.05).Compared with group E,MAP in group S at T1,T2 and T3,HR and SpO2 at T1 and T2 in group E were decreased,the differences were statistically significant(P<0.05).Compared with the group E,the additional dosage of ciprofol,the incidence of hypoxemia and hypotension were increased,the satisfaction of anesthesiologists was decreased in group S,the differences were statistically significant(P<0.05).Conclusion For opioid-free anesthesia,esketamine is feasible for colonoscopy anesthesia in elderly patient,and the incidence of hypoxemia and hypotension is low.