Efficacy and safety of esketamine combined with propofol for conscious sedation in painless colonoscopy: a prospective, randomized, double-blind controlled clinical trial.

IF 2.3 3区 医学 Q2 ANESTHESIOLOGY
Lizhu Xiao, Zhenghua Zhang, Jing Lu, Zhaoguo Liu, Jiaoling Zhang, Lu Kang, Jiefu Tang, Xiaohua Zou
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引用次数: 0

Abstract

Background: We explored the efficacy and safety of esketamine combined with propofol for conscious sedation in painless colonoscopy.

Methods: A total of 195 patients who underwent painless colonoscopy surgery were randomly divided into three groups: the propofol deep sedation group (group DS), the sufentanil combined with propofol for conscious sedation (group CS1) and the esketamine combined with propofol for conscious sedation (group CS2). The primary outcomes of this study included the incidence of hypoxemia, hypotension, hypertension, and bradycardia and excellent and good rates of anaesthesia during colonoscopy. The secondary outcomes included perioperative changes in vital signs (MAP, HR, and SpO2), anaesthesia induction time, dischargeable time, patient and endoscopist satisfaction scores, and incidence of postoperative nausea and vomiting (PONV), drowsiness, dizziness, propofol injection pain, assisted ventilation and vasoactive medications.

Results: The incidence of intraoperative hypoxemia in the DS group was significantly greater than that in the CS1 and CS2 groups (χ2 = 7.081, P = 0.029). The incidence of hypotension in the CS2 group was significantly lower than that in the DS and CS1 groups (χ2 = 16.278, P < 0.001). The risk of hypoxemia was 5.727 times higher in Group DS than in Group CS2 (OR 5.727; 95%CI 1.203-27.273), and the risk of hypotension was 9.864 times higher in Group DS than in Group CS2 (OR 9.864; 95%CI 2.770-35.120). The risk of hypotension in Group CS1 was 5.167 times that in Group CS2 (OR 5.167; 95%CI 1.396-19.117). The incidence of propofol injection pain, assisted ventilation, ephedrine usage and drowsiness in the DS group was significantly greater than that in the CS1 and CS2 groups (χ2 = 57.618, P < 0.001; χ2 = 9.544, P = 0.008; χ2 = 14.820, P = 0.001; χ2 = 37.257, P < 0.001). The incidence of dizziness during recovery in the CS1 group was significantly greater than that in the DS and CS2 groups (χ2 = 6.594, P = 0.037). The dischargeable time in the DS group was significantly greater than that in the CS1 and CS2 groups (F = 53.039, P < 0.001). The satisfaction scores of the endoscopist and patients in the DS group were significantly lower than those in the CS1 and CS2 groups (F = 17.390, P < 0.001; F = 19.282; P < 0.001).

Conclusions: In conclusion, esketamine combined with propofol for conscious sedation can be safely and effectively used for painless colonoscopy and has fewer complications.It is recommended for painless colonoscopy.

艾司卡胺联合异丙酚用于无痛结肠镜检查的意识镇静的有效性和安全性:一项前瞻性、随机、双盲对照临床试验。
背景:我们探讨了艾司卡胺联合异丙酚在无痛结肠镜检查中意识镇静的有效性和安全性:方法:将接受无痛结肠镜手术的 195 名患者随机分为三组:丙泊酚深度镇静组(DS 组)、舒芬太尼联合丙泊酚意识镇静组(CS1 组)和艾司卡胺联合丙泊酚意识镇静组(CS2 组)。这项研究的主要结果包括低氧血症、低血压、高血压和心动过缓的发生率,以及结肠镜检查期间的麻醉优良率和良好率。次要结果包括围手术期生命体征变化(MAP、HR 和 SpO2)、麻醉诱导时间、可出院时间、患者和内镜医师满意度评分,以及术后恶心呕吐(PONV)、嗜睡、头晕、异丙酚注射疼痛、辅助通气和血管活性药物的发生率:DS 组术中低氧血症的发生率明显高于 CS1 和 CS2 组(χ2 = 7.081,P = 0.029)。CS2 组低血压的发生率明显低于 DS 组和 CS1 组(χ2 = 16.278,P 2(OR 5.727;95%CI 1.203-27.273),DS 组发生低血压的风险是 CS2 组的 9.864 倍(OR 9.864;95%CI 2.770-35.120)。CS1 组发生低血压的风险是 CS2 组的 5.167 倍(OR 5.167;95%CI 1.396-19.117)。DS 组的异丙酚注射疼痛、辅助通气、麻黄碱使用和嗜睡发生率显著高于 CS1 组和 CS2 组(χ2 = 57.618,P 1 组显著高于 DS 组和 CS2 组(χ2 = 6.594,P = 0.037)。DS 组的可出院时间明显大于 CS1 组和 CS2 组(F = 53.039,P 1 和 CS2 组(F = 17.390,P 结论):总之,艾司卡胺联合异丙酚意识镇静可安全有效地用于无痛结肠镜检查,且并发症较少,推荐用于无痛结肠镜检查。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
BMC Anesthesiology
BMC Anesthesiology ANESTHESIOLOGY-
CiteScore
3.50
自引率
4.50%
发文量
349
审稿时长
>12 weeks
期刊介绍: BMC Anesthesiology is an open access, peer-reviewed journal that considers articles on all aspects of anesthesiology, critical care, perioperative care and pain management, including clinical and experimental research into anesthetic mechanisms, administration and efficacy, technology and monitoring, and associated economic issues.
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