小剂量艾司氯胺酮在肥胖患者无痛胃镜诊疗中的应用

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Abstract Objective To investigate the efficacy and safety of low-dose esketamine in painless diagnosis in obese patients. Methods A total of 120 obese patients undergoing painless gastroscopy in General Hospital of Western Theater Command from September 2021 to June 2022 were randomly divided into two groups, with 60 cases in each group. Group A was given esketamine 0.2 mg/kg, group B was given sufentanil 0.1 μg/kg before operation, and then propofol 1-2 mg/kg was given. Heart rate (HR), mean arterial pressure (MAP) and oxygen saturation (SpO₂) were compared between the two groups before anesthesia (T₁), at the time of gastroscopy insertion (T₂), at the end of surgery (T₃), and 10 minutes after operation.Respiratory rate (RR), the number of cases of intraoperative cough, body movement, operation stop and application of viable vessels were recorded. The operation time, awakening time and propofol dosage of the two groups were recorded. The number of postoperative nausea, vomiting, delirium and the evaluation by the operator on the effect of anesthesia were also recorded. Results HR, MAP, RR and SpO₂ of group B at T₂ and T₃ were significantly lower than those at T₁, and were significant lower than those of group B (P<0.05). The cases of intraoperative cough, body movement, operation stop and use of vasoactive drugs in group A were significantly lower than those in group B (P<0.05). The dosage of propofol in group A was significantly less than that in group B. The operation time of group A was shorter than that of group B; the number of operators’ good evaluation cases was higher than that of group B (P<0.05).There were no significant differences in recovery time, postoperative nausea and vomiting or deliration cases between the two groups (P>0.05). Conclusions Low-dose esketamine used in the gastroscopy of obese patients is more safe and effective, which is characterized by more stable circulation, less respiratory depression and more satisfactory anesthetic effect.

Key words： esketamine sufentanil propofol obesity painless gastroscope

Received: 11 September 2023

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	GONG Huaqu
	LIN Lu
	GONG Gu

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GONG Huaqu,LIN Lu,GONG Gu. Application of low-dose esketamine in painless gastroscopy in obese patients[J]. Med. J. Chin. Peop. Armed Poli. Forc., 2024, 35(4): 343-346.

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http://journal08.magtechjournal.com/Jwk_wjyx/EN/ OR http://journal08.magtechjournal.com/Jwk_wjyx/EN/Y2024/V35/I4/343

[5]	宋海涛,符玲玲.舒芬太尼复合丙泊酚在无痛胃镜麻醉中的应用[J]. 中国现代医生, 2020, 58(5):133-136.
[6]	谭健安.小剂量舒芬太尼复合丙泊酚用于无痛胃镜治疗的麻醉效果[J]. 临床合理用药,2021, 14(1):79-80.
[1]	葛昱宇.分析丙泊酚应用于无痛胃镜中的麻醉治疗效果[J].临床医药文献电子杂志,2020,7(51):33-34.
[7]	Xiao Q S,YangY Y,ZhouY B,et al.Comparison of nasopharyngeal airway device and nasal oxygen tube in obese patients undergoing intravenous anesthesia for gastroscopy: a prospective and randomized study[J]. Gastroenterol Res Pract,2016:2641257.
[2]	Li Y P,Zhou Y.Differential dosing of oxycodone in combination with propofol in diagnostic painless gastroscopy in elderly patients: a prospective randomized controlled trial[J]. Medicine (Baltimore),2022,101(51):e32427.
[8]	Zheng L B,Wang Y T, Ma Q,et al.Efficacy and safety of a subanesthetic dose of esketamine combined with propofol in patients with obesity undergoing painless gastroscopy: a prospective, double-blind, randomized controlled trial[J]. Drug Des Devel Ther,2023,4(17):1347-1356.
[3]	Wang J F,Xu H J,Xue M,et al. He predicting the best fit based on the synergistic interaction of remifentanil and propofol at the corrected dose in elderly patients undergoing painless gastroscopy[J]. Am J Transl Res,2022,14(11):8390-8397.
[9]	刘丝濛, 岳云. 右氯胺酮的药理学特点和临床应用[J]. 国际麻醉学与复苏杂志,2016,37(1):62-66,71.
[4]	王浩然,郭苗,冯峰.不同首剂量瑞芬太尼复合丙泊酚在无痛胃镜麻醉中的应用比较[J].中国医药科学,2020,10(23):183-185.
[10]	Patrizi A, Picard N, Simon A J,et al. Chronic administration of the N-methyl-D-apartate receptor antagonist ketamine improves Rett syndrome phenotype[J].Biol Psychiatry,2016,79(9): 755-764.
[5]	宋海涛,符玲玲.舒芬太尼复合丙泊酚在无痛胃镜麻醉中的应用[J]. 中国现代医生, 2020, 58(5):133-136.
[11]	Jonkman K, Rijnsoever E, Olofsen E, et al. E sketanmine counters opioid-induced respiratory depression[J].Br J Anaesth, 2018,120(5):1117-1127.
[6]	谭健安.小剂量舒芬太尼复合丙泊酚用于无痛胃镜治疗的麻醉效果[J]. 临床合理用药,2021, 14(1):79-80.
[12]	Zhao H, Cotton J F, Long X, et al.The effect of atomoxetine,a selective　norepinephrine reuptake inhibitor, on respiratory arrest and cardiores piriatory function the DBA/1 mouse model of SUDEP[J]. Epilepsy Res, 2017, 137:139-144.
[7]	Xiao Q S,YangY Y,ZhouY B,et al.Comparison of nasopharyngeal airway device and nasal oxygen tube in obese patients undergoing intravenous anesthesia for gastroscopy: a prospective and randomized study[J]. Gastroenterol Res Pract,2016:2641257.
[13]	史媛, 董贝贝, 于泳浩. 胃肠内镜检查中镇静镇痛药物应用的研究进展[J]. 中国医药导报, 2021, 17(34):64 -67.
[8]	Zheng L B,Wang Y T, Ma Q,et al.Efficacy and safety of a subanesthetic dose of esketamine combined with propofol in patients with obesity undergoing painless gastroscopy: a prospective, double-blind, randomized controlled trial[J]. Drug Des Devel Ther,2023,4(17):1347-1356.
[14]	Zanos P, Moaddel R, Morris P J, et al. NMDAR inhibition-independent antidepressant actions of ketamine metabolites[J]. Nature, 2016,533(7604):481-486.
[9]	刘丝濛, 岳云. 右氯胺酮的药理学特点和临床应用[J]. 国际麻醉学与复苏杂志,2016,37(1):62-66,71.
[15]	Trimmel H, Helbok R, Staudinger T, et al.S(+)-ketamine:current trends in emergency and intensive care medicine[J].Wien Klin Wochenschr,2018,130(9-10): 356-366.
[10]	Patrizi A, Picard N, Simon A J,et al. Chronic administration of the N-methyl-D-apartate receptor antagonist ketamine improves Rett syndrome phenotype[J].Biol Psychiatry,2016,79(9): 755-764.
[16]	杨鸣.艾司氯胺酮对开胸手术患者应激反应的影响[J].当代医学,2022,(28)2:102-104.
[11]	Jonkman K, Rijnsoever E, Olofsen E, et al. E sketanmine counters opioid-induced respiratory depression[J].Br J Anaesth, 2018,120(5):1117-1127.
[17]	钱夏丽,夏凡, 沈晓凤, 等.艾司氯胺酮复合丙泊酚在宫腔镜检查术中的应用[J]. 临床麻醉学杂志,2021, 37(7):706-708.
[12]	Zhao H, Cotton J F, Long X, et al.The effect of atomoxetine,a selective　norepinephrine reuptake inhibitor, on respiratory arrest and cardiores piriatory function the DBA/1 mouse model of SUDEP[J]. Epilepsy Res, 2017, 137:139-144.
[18]	卢光涛, 陈健,周智丽, 等.艾司氯胺酮复合右美托咪定在儿童扁桃体切除术中的应用效果[J].温州医科大学学报,2021,51(11):881-884.
[13]	史媛, 董贝贝, 于泳浩. 胃肠内镜检查中镇静镇痛药物应用的研究进展[J]. 中国医药导报, 2021, 17(34):64 -67.
[19]	邢婧,杨沫,王希.艾司氯胺酮在肥胖孕妇剖宫产全麻中的应用研究[J]. 中国计划生育和妇产科, 2021, 13(11):69-72.
[14]	Zanos P, Moaddel R, Morris P J, et al. NMDAR inhibition-independent antidepressant actions of ketamine metabolites[J]. Nature, 2016,533(7604):481-486.
[20]	宋兆卿,李冬冬.小剂量艾司氯胺酮在老年患者无痛胃肠镜诊疗中的应用[J]. 潍坊医学院学报,2021,43 (6):476-477.
[15]	Trimmel H, Helbok R, Staudinger T, et al.S(+)-ketamine:current trends in emergency and intensive care medicine[J].Wien Klin Wochenschr,2018,130(9-10): 356-366.
[16]	杨鸣.艾司氯胺酮对开胸手术患者应激反应的影响[J].当代医学,2022,(28)2:102-104.
[17]	钱夏丽,夏凡, 沈晓凤, 等.艾司氯胺酮复合丙泊酚在宫腔镜检查术中的应用[J]. 临床麻醉学杂志,2021, 37(7):706-708.
[18]	卢光涛, 陈健,周智丽, 等.艾司氯胺酮复合右美托咪定在儿童扁桃体切除术中的应用效果[J].温州医科大学学报,2021,51(11):881-884.
[19]	邢婧,杨沫,王希.艾司氯胺酮在肥胖孕妇剖宫产全麻中的应用研究[J]. 中国计划生育和妇产科, 2021, 13(11):69-72.
[20]	宋兆卿,李冬冬.小剂量艾司氯胺酮在老年患者无痛胃肠镜诊疗中的应用[J]. 潍坊医学院学报,2021,43 (6):476-477.