环泊酚和丙泊酚在老年患者纤维结肠镜治疗中镇静效果比较

Comparison of sedative effect of ciprofol and propofol in elder patients undergoing fibrocolonoscopy treatment

中文关键词: 环泊酚  丙泊酚  纤维结肠镜治疗  老年  镇静效果

英文关键词: Ciprofol  Propofol  Fibrocolonoscopy treatment  Aged  Sedative effect

中文摘要:

      
目的 比较环泊酚和丙泊酚在老年患者纤维结肠镜治疗中的镇静效果。

方法 选择行纤维结肠镜治疗的老年患者330例，男179例，女151例，年龄65～84岁，BMI 18～29 kg/m²，ASA Ⅰ或Ⅱ级。随机分为两组：环泊酚组（C组，n=160）和丙泊酚组（P组，n=162）。C组麻醉诱导给予环泊酚0.4 mg/kg，麻醉维持泵注环泊酚1～1.5 mg·kg^-1·h^-1，P组麻醉诱导给予丙泊酚2 mg/kg，麻醉维持泵注丙泊酚4～6 mg·kg^-1·h^-1。记录镇静成功率、诱导时间、完全清醒时间，麻醉诱导前（T0）、进镜时（T1）、进镜后10 min（T2）、完全清醒时（T3）时SBP、DBP、BIS，术中心动过缓、低血压、低氧血症、注射痛、体动，气道干预、术中追加镇静和术后恶心呕吐发生情况。

结果 与P组比较，C组T2时SBP、DBP明显升高（P<0.05），T2和T3时BIS明显降低（P<0.05），术中低氧血症和注射痛发生率明显降低（P<0.05）。两组镇静成功率、诱导时间、完全清醒时间，术中心动过缓、低血压、体动发生率，气道干预、术中追加镇静和术后恶心呕吐发生率差异无统计学意义。

结论 与丙泊酚比较，环泊酚在老年患者纤维结肠镜治疗中有同样的镇静效果，且有着更低的低氧血症和注射痛发生率，值得临床推广。

英文摘要:

      
Objective To compare the sedative effect of ciprofol and propofol in elderly patients undergoing fibrocolonoscopy treatment.

Methods A total of 330 elderly patients, 179 males and 151 females, aged 65-84 years, BMI 18-29 kg/m², and ASA phsical stutas Ⅰ or Ⅱ, were selected for colonoscopy treatment who were randomly divided into two groups: the ciprofol group (group C, n = 160) and the propofol group (group P, n = 162). Group C was given ciprofol 0.4 mg/kg for anesthesia induction and ciprofol pump intravenous 1-1.5 mg·kg^-1·h^-1 for anesthesia maintenance. Group P was given propofol 2 mg/kg for anesthesia induction and propofol intravenous pump at 4-6 mg·kg^-1·h^-1 for anesthesia maintenance. The success rate of sedation, induction time, time of full consciousness, SBP, DBP, BIS before anesthesia induction (T₀), at entry (T₁), 10 minutes after entry (T₂), and at full consciousness (T₃), and the incidence of bradycardia, hypotension, hypoxemia, injection pain, body movements, airway intervention, intraoperative addition, and postoperative nausea and vomiting were recorded.

Results Compared with group P, SBP and DBP were significantly increased in group C at T₂ (P < 0.05), BIS values were significantly decreased at T₂ and T₃ (P < 0.05), and the incidence of hypoxemia and injection pain were significantly decreased in the course of diagnosis and treatment (P < 0.05). There were no significant differences in sedation success rate, induction time, full consciousness time, and incidence of adverse events including bradycardia, hypotension, body movement, airway intervention, intraoperative addition, and nausea and vomiting between the two groups.

Conclusion Compared with propofol, ciprofol has the same sedative effect and lower incidence of hypoxemia and injection pain in the fibrcolonoscopy treatment of elderly patients, which is worth of clinical promotion.