Abstract
Objective To compare the efficacy and safety of ciprofol combined with esketamine or remifentanil in painless gastroscopy and colonoscopy for obese patients.Methods 126 obese patients due to abdominal pain or loose stools from January to October 2024 and were scheduled to undergo painless gastroscopy combined with colonoscopy were selected and divided into the observation group and the control group by random number table method,with 63 cases in each group.The anesthesia and analgesia regimen for the observation group was ciprofol combined with esketamine,while that for the control group was ciprofol combined with remifentanil.The hemodynamic indicators[heart rate(HR),percutaneous arterial oxygen saturation(SpO2),and mean arterial pressure(MAP)]of the two groups of patients at different time points[immediately before anesthesia induction(T0),immediately after the completion of anesthesia induction(T1),when gastroscopy passed through the laryngeal area(T2),when colonoscopy passed through the hepatic flexure(T3),and immediately after the end of the examination(T4)]were compared.The anesthesia-related conditions(gastroscopy and colonoscopy examination time,anesthesia induction time,anesthesia recovery time and discharge time)of the two groups of patients were compared.The consumption of ciprofol,the use of vasoactive drugs and the occurrence of adverse reactions were compared between the two groups of patients.The visual analogue scale(VAS)scores for pain at the time of awakening and at rest 30 min after awakening were compared between the two groups of patients,as well as the satisfaction scores of patients and anesthesiologists.Results There were statistically significant differences in the time,intergroup and interaction effects of MAP,HR and SpO2 between the two groups of patients(P<0.05).The MAP and HR of the observation group at time points T1,T2,T3 and T4 were significantly higher than those of the control group,and the SpO2 of the observation group at time points T1,T2 and T3 was significantly higher than that of the control group.The differences were statistically significant(P<0.05).The MAP at time points T1,T2 and T3 were significantly lower than that at time point T0,and the HR at the T3 time point was significantly lower than that at time point T0 in the observation group.The differences were statistically significant(P<0.05).In the control group,MAP and HR at time points T1,T2,T3 and T4 were significantly lower than those at time point T0,and SpO2 at time points T1,T2 and T3 were significantly lower than that at time point T0.The differences were all statistically significant(P<0.05).There were no statistically significant differences in gastroscopy and colonoscopy examination time,anesthesia induction time,anesthesia recovery time and discharge time between the two groups of patients(P>0.05).The induction consumption,maintenance consumption,and total consumption in the observation group were significantly less than those in the control groupl,usage rate of vasoactive drugs in the observation group was significantly lower than that in the control group,and the differences were statistically significant(P<0.05).The incidences of respiratory depression(0.00%),hypotension(1.59%),and bradycardia(0.00%)in the observation group were significantly lower than those in the control group(9.52%,12.70%,and 11.11%),and the differences were statistically significant(P<0.05).Comparison of the incidences of airway obstruction,nausea and vomiting,dizziness and headache,injection pain,choking cough,and body movement between the two groups were no statistically significant differences(P>0.05).The VAS scores of pain at rest in the observation group at awakening and 30 min after awakening were significantly lower than those in the control group,and the differences were statistically significant(P<0.05).The comparison of the satisfaction scores of patients and anesthesiologists in the observation group showed statistically significant differences(P<0.05).Conclusion In painless gastroscopy and colonoscopy for obese patients the application of ciprofol combined with esketamine outperforms ciprofol combined with remifentanil in maintaining hemodynamic stability,reducing respiratory depression and circulatory inhibition in patients,decreasing ciprofol dose,and improving patient and anesthesiologist satisfaction.It is a worthy clinical application.关键词
艾司氯胺酮/胃镜检查/瑞芬太尼/结肠镜检查/环泊酚/肥胖/全身麻醉Key words
esketamine/gastroscopy/remifentanil/colonoscopy/ciprofol/obesity/general anesthesia分类
医药卫生
