Effect of etomidate added to propofol target-controlled infusion in bidirectional endoscopy: A randomized clinical trial.

IF 1.4 Q4 GASTROENTEROLOGY & HEPATOLOGY
Hui-Rong Luo, An-Di Chen, Jing-Fang Lin, Peng Ye, Ying-Jie Chen, Ming-Xue Lin, Pin-Zhong Chen, Xiao-Hui Chen, Xiao-Chun Zheng
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引用次数: 0

Abstract

Background: Propofol has been widely used in bidirectional gastrointestinal endoscopy sedation; however, it frequently leads to cardiovascular adverse events and respiratory depression. Propofol target-controlled infusion (TCI) can provide safe sedation but may require higher dosages of propofol. On the contrary, etomidate offers hemodynamic stability.

Aim: To evaluate the effect of different dose etomidate added to propofol TCI sedation during same-visit bidirectional endoscopy.

Methods: A total of 330 patients from Fujian Provincial Hospital were randomly divided into three groups: P, 0.1EP, and 0.15EP. Patients in the P group received propofol TCI only, with an initial effect-site concentration of the propofol TCI system of 3.0 mg/mL. Patients in the 0.1EP and 0.15EP groups received 0.1 and 0.15 mg/kg etomidate intravenous injection, respectively, followed by propofol TCI.

Results: Patients in the 0.15EP group had higher mean blood pressure after induction than the other groups (P group: 78 mmHg, 0.1EP group: 82 mmHg, 0.15EP group: 88 mmHg; P < 0.05). Total doses of propofol consumption significantly decreased in the 0.15EP group compared with that in the other groups (P group: 260.6 mg, 0.1EP group: 228.1 mg, 0.15EP group: 201.2 mg; P < 0.05). The induction time was longer in the P group than in the other groups (P group: 1.9 ± 0.7 minutes, 0.1EP group: 1.2 ± 0.4 minutes, 0.15EP group: 1.1 ± 0.3 minutes; P < 0.01). The recovery time was shorter in the 0.15EP group than in the other groups (P group: 4.8 ± 2.1 minutes, 0.1EP group: 4.5 ± 1.6 minutes, 0.15EP group: 3.9 ± 1.4 minutes; P < 0.01). The incidence of hypotension (P group: 36.4%, 0.1EP group: 29.1%, 0.15EP group: 11.8%; P < 0.01) and injection pain was lower in the 0.15EP group than in the other groups (P < 0.05). Furthermore, the incidence of respiratory depression was lower in the 0.15EP group than in the P group (P < 0.05). Additionally, the satisfaction of the patient, endoscopist, and anesthesiologist was higher in the 0.15EP group than in the other groups (P < 0.05).

Conclusion: Our findings suggest that 0.15 mg/kg etomidate plus propofol TCI can significantly reduce propofol consumption, which is followed by fewer cardiovascular adverse events and respiratory depression, along with higher patient, endoscopist, and anesthesiologist satisfaction.

异丙酚靶控输注中加入依托咪酯在双向内镜检查中的作用:一项随机临床试验。
背景:异丙酚已广泛应用于胃肠道内镜双向镇静;然而,它经常导致心血管不良事件和呼吸抑制。异丙酚靶控输注(TCI)可以提供安全镇静,但可能需要更高剂量的异丙酚。相反,依托咪酯提供血流动力学稳定性。目的:评价异丙酚TCI镇静术中不同剂量依托咪酯加用的效果。方法:福建省立医院住院患者330例,随机分为P组、0.1EP组和0.15EP组。P组患者仅接受异丙酚TCI治疗,异丙酚TCI系统初始效应位点浓度为3.0 mg/mL。0.1 ep组和0.15 ep组患者分别给予0.1和0.15 mg/kg依托咪酯静脉注射,随后给予异丙酚TCI。结果:0.15EP组患者诱导后平均血压高于其他组(P组:78 mmHg, 0.1EP组:82 mmHg, 0.15EP组:88 mmHg;P < 0.05)。与其他各组相比,0.15EP组丙泊酚总用量显著降低(P组:260.6 mg, 0.1EP组:228.1 mg, 0.15EP组:201.2 mg;P < 0.05)。P组诱导时间明显长于其他各组(P组:1.9±0.7 min, 0.1EP组:1.2±0.4 min, 0.15EP组:1.1±0.3 min;P < 0.01)。0.15EP组恢复时间短于其他各组(P组:4.8±2.1 min, 0.1EP组:4.5±1.6 min, 0.15EP组:3.9±1.4 min;P < 0.01)。低血压发生率(P组:36.4%,0.1EP组:29.1%,0.15EP组:11.8%;P < 0.01),且0.15EP组注射痛明显低于其他各组(P < 0.05)。此外,0.15EP组呼吸抑制发生率低于P组(P < 0.05)。此外,0.15EP组患者满意度、内镜医师满意度和麻醉医师满意度均高于其他组(P < 0.05)。结论:我们的研究结果表明,0.15 mg/kg依托咪酯加异丙酚TCI可显著减少异丙酚的用量,从而减少心血管不良事件和呼吸抑制,同时提高患者、内镜医师和麻醉师的满意度。
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来源期刊
World Journal of Gastrointestinal Endoscopy
World Journal of Gastrointestinal Endoscopy GASTROENTEROLOGY & HEPATOLOGY-
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