肿瘤预防与治疗2025，Vol.38Issue(10)：868-874,7.DOI:10.3969/j.issn.1674-0904.2025.10.003
艾司氯胺酮复合丙泊酚麻醉对疑似消化道早癌无痛胃肠镜检查患者血流动力学及苏醒质量的影响
Effects of Esketamine Combined with Propofol Anesthesia on Hemody-namics and Recovery Quality in Patients with Suspected Early Gastrointes-tinal Cancer during Painless Gastrointestinal Endoscopy
摘要
Abstract
Objective:To explore the effects of esketamine combined with propofol anesthesia on hemodynamics and re-covery quality in patients with suspected early gastrointestinal cancer during painless gastrointestinal endoscopy.Methods:A total of 165 patients with suspected early gastrointestinal cancer undergoing painless gastrointestinal endoscopy at our hospital between September 2022 and November 2023 were en-rolled.Using a random number table,the patients were randomized into three groups of 55 patients each.Groups A,B,and C received esketamine at doses of 0.2,0.35,and 0.5 mg/kg,respectively,combined with propofol administered by target-controlled infusion.Hemodynamic parameters,anesthetic dosage,recovery quality,postoperative pain,and adverse reac-tions were compared among the three groups.Results:The recovery time was shortest in Group B[(7.36±2.12)min],followed by Group A[(11.14±2.37)min],and was longest in Group C[(15.08±2.85)min](all P＜0.05).Scores on the Quality of Recovery-40 questionnaire were significantly higher in Group B(180.49±5.47)than in both Group A(171.63±6.58)and Group C(173.24±6.96)(P＜0.05).Compared with baseline immediately before anesthesia in-duction(TO),Group A showed significant decreases in heart rate(HR)and mean arterial pressure(MAP)at T1(immedi-ately before endoscope insertion),T2(when the endoscope reached the examination endpoint),and T3(upon awakening)(P＜0.05).Group B exhibited a significant increase in HR at T1 and T2(P＜0.05).Group C demonstrated significant increases in HR and MAP at T1,T2,and T3(P＜0.05).However,no significant changes in blood oxygen saturation were observed at T1-T3 in any of the three groups(P＞0.05).Although HR and MAP from T1 to T3 were significantly higher in both Group B and Group C compared to Group A(P＜0.05),the values in Group B were significantly lower than those in Group C(P＜0.05).The target induction concentration and total dosage of propofol sequentially decreased from Group A to B to C(P＜0.05).The anesthesia onset time was longer in Group A than in Groups B and C(P＜0.05).The incidence of body movement was higher in Group A than in Group C(P＜0.05).Compared with the values at the time of awakening,the Visual Analogue Scale(VAS)scores at 30 minutes after awakening significantly increased in all three groups(P＜0.05).Furthermore,the VAS score in Group A at 30 minutes was significantly higher than those in both Group B and Group C(P＜0.05).The differences in the incidence of hypoxemia,respiratory depression,nausea and vomiting,and bucking among the three groups were not statistically significant(all P＞0.05).Conclusion:The use of 0.35 mg/kg of esketamine combined with propofol provides more stable hemodynamics and better recovery quality without increasing the incidence of ad-verse reactions in patients with suspected early gastrointestinal cancer undergoing painless gastrointestinal endoscopy.关键词
艾司氯胺酮/无痛胃肠镜检查/疑似消化道早癌/丙泊酚/血流动力学/苏醒质量Key words
Esketamine/Painless gastrointestinal endoscopy/Suspected early gastrointestinal cancer/Propofol/Hemody-namics/Quality of recovery分类
医药卫生引用本文复制引用
赵丽,常钧,王宏志,赵艳丽,马秀丽..艾司氯胺酮复合丙泊酚麻醉对疑似消化道早癌无痛胃肠镜检查患者血流动力学及苏醒质量的影响[J].肿瘤预防与治疗,2025,38(10):868-874,7.基金项目
This study was supported by grants from Health Commission of Shanxi Province(No.2023015)and Shanxi Medical Doctor Association(No.2023HX02).山西省卫生健康委科研课题(编号:2023015) （No.2023015）
山西省医师协会医师临床科研项目(编号:2023HX02) （编号:2023HX02）
