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奥施康定-丙泊酚联合用药与芬太尼-丙泊酚联合用药在老年患者治疗性内镜逆行胰胆管造影术中清醒镇静中的疗效比较。

Efficacy of an Oxycodone-Propofol Combination versus a Fentanyl-Propofol Combination in Conscious Sedation during Therapeutic Endoscopic Retrograde Cholangiopancreatography in Elderly Patients.

机构信息

Department of Anesthesiology, Zhongnan Hospital of Wuhan University, Wuhan, China.

Department of Gastroenterology, Zhongnan Hospital of Wuhan University, Wuhan, China.

出版信息

Gerontology. 2021;67(1):9-16. doi: 10.1159/000511173. Epub 2020 Dec 1.

Abstract

BACKGROUND

With a rapidly aging population, the need for endoscopic retrograde cholangiopancreatography (ERCP) is increasing. The commonly used sedation anesthesia in ERCP is a combination of propofol and fentanyl, even though fentanyl may cause some adverse reactions such as respiratory depression.

OBJECTIVES

This study aimed to evaluate the efficacy of oxycodone combined with propofol versus fentanyl combined with propofol for sedation anesthesia during ERCP.

METHODS

A total of 193 patients aged from 65 to 80 years undergoing ERCP were enrolled and randomized into two groups: an "oxycodone combined with propofol" group (group OP, n = 97) and a "fentanyl combined with propofol" group (group FP, n = 96). The rate of perioperative adverse events as well as the recovery time, patients' satisfaction, and endoscopists' satisfaction were noted.

RESULTS

There was no difference in the frequency of hypotension or bradycardia between the two groups, but there were more episodes of desaturation (SpO2 <90% for >10 s in 8.3%), postoperative nausea (7.3%), and vomiting (5.2%) in group FP than in group OP. Patients' satisfaction in group FP was lower than that in group OP. The recovery time was longer in group FP than in group OP.

CONCLUSIONS

Oxycodone combined with propofol was effective in ERCP, with a low incidence of perioperative adverse events.

摘要

背景

随着人口老龄化的迅速发展,对内镜逆行胰胆管造影术(ERCP)的需求正在增加。ERCP 中常用的镇静麻醉是丙泊酚和芬太尼的联合用药,尽管芬太尼可能会引起一些不良反应,如呼吸抑制。

目的

本研究旨在评估羟考酮联合丙泊酚与芬太尼联合丙泊酚用于 ERCP 镇静麻醉的效果。

方法

共纳入 193 名年龄在 65 至 80 岁之间接受 ERCP 的患者,并随机分为两组:“羟考酮联合丙泊酚”组(OP 组,n = 97)和“芬太尼联合丙泊酚”组(FP 组,n = 96)。记录围手术期不良事件的发生率以及恢复时间、患者满意度和内镜医师满意度。

结果

两组之间低血压或心动过缓的发生率没有差异,但 FP 组比 OP 组出现更多的低氧血症(SpO2<90%持续>10s 的次数为 8.3%)、术后恶心(7.3%)和呕吐(5.2%)。FP 组的患者满意度低于 OP 组。FP 组的恢复时间长于 OP 组。

结论

羟考酮联合丙泊酚在 ERCP 中有效,围手术期不良事件发生率低。

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