Zheng Li-Yan, Mi Sui-Cai, Wu Ling-Yan, Xu Zheng-Jin, Lu Hao
Department of Anesthesiology, Xiamen Hospital of Traditional Chinese Medicine, Xiamen 361000, Fujian Province, China.
Department of Oncology, Xiamen Hospital of Traditional Chinese Medicine, Xiamen 361000, Fujian Province, China.
World J Gastrointest Endosc. 2023 Feb 16;15(2):56-63. doi: 10.4253/wjge.v15.i2.56.
Painless gastroscopy is a widely used diagnostic and therapeutic technology in clinical practice. Propofol combined with opioids is a common drug for painless endoscopic sedation and anaesthesia. In clinical work, adverse drug reactions of anaesthesia schemes are often one of the important areas of concern for doctors and patients. With the increase in propofol dosage, the risk of serious adverse drug reactions, such as respiratory depression and hypotension, increases significantly; the use of opioids often causes gastrointestinal reactions in patients after examination, such as nausea, vomiting, delayed recovery of gastrointestinal function and other complications, which seriously affect their quality of life.
To observe the effect of wrist-ankle acupuncture therapy on the anaesthesia regimen and anaesthesia-related complications during and after painless gastroscopy examination.
Two hundred patients were selected and randomly divided into a treatment group ( = 100) and a control group ( = 100). Both groups were routinely anaesthetized with the nalbuphine and propofol regimen, gastroscopy began after the patient lost consciousness, and given supportive treatment and vital sign monitoring. If the patient interrupted the surgery due to intraoperative torsion, intravenous propofol was used to relieve his or her discomfort. The treatment group received wrist-ankle acupuncture on this basis.
The general data before treatment, American Society of Anesthesiologist (ASA) grade and operation time between the two groups was no significant difference. The Wakeup time, and the Self-ambulation time in the treatment group was significantly faster than that in the control group ( < 0.05). The total dose of propofol in the treatment group was 109 ± 8.17 mg, significantly lower than that in the control group ( < 0.05). The incidence of respiratory depression and hypotension was not significantly different, but the incidence of hiccups was significantly lower than that in the control group ( < 0.05). After the examination, the incidence of nausea, vomiting, abdominal distension, and abdominal pain was 11%, 8%, 6%, and 5%, respectively, which was significantly lower than that in the control group ( < 0.05). In addition, both the operators and the patients were more satisfied with this examination, with no significant difference between the groups ( > 0.05).
Wrist-ankle acupuncture treatment can optimize the painless gastroscopy and anaesthesia scheme, reduces propofol total dose; shortens patient Wakeup time and Self-ambulation time, improves patient compliance and tolerance, is beneficial to clinical application.
无痛胃镜检查是临床广泛应用的诊断和治疗技术。丙泊酚联合阿片类药物是无痛内镜镇静麻醉常用药物。临床工作中,麻醉方案的药物不良反应常是医患关注的重点领域之一。随着丙泊酚剂量增加,呼吸抑制、低血压等严重药物不良反应风险显著增加;阿片类药物的使用常导致患者检查后出现胃肠道反应,如恶心、呕吐、胃肠功能恢复延迟等并发症,严重影响其生活质量。
观察腕踝针疗法对无痛胃镜检查术中及术后麻醉方案及麻醉相关并发症的影响。
选取200例患者,随机分为治疗组(n = 100)和对照组(n = 100)。两组均采用纳布啡联合丙泊酚方案常规麻醉,待患者意识消失后开始胃镜检查,并给予支持治疗及生命体征监测。若患者因术中扭动中断手术,静脉推注丙泊酚缓解不适。治疗组在此基础上加用腕踝针治疗。
两组治疗前一般资料、美国麻醉医师协会(ASA)分级及手术时间比较,差异无统计学意义。治疗组苏醒时间、自主行走时间均明显快于对照组(P < 0.05)。治疗组丙泊酚总用量为109 ± 8.17 mg,明显低于对照组(P < 0.05)。呼吸抑制、低血压发生率比较,差异无统计学意义,但呃逆发生率明显低于对照组(P < 0.05)。检查后,恶心、呕吐、腹胀、腹痛发生率分别为11%、8%、6%、5%,明显低于对照组(P < 0.05)。此外,术者及患者对本次检查的满意度均较高,组间比较差异无统计学意义(P > 0.05)。
腕踝针治疗可优化无痛胃镜麻醉方案,减少丙泊酚总用量;缩短患者苏醒时间及自主行走时间,提高患者依从性及耐受性,有利于临床推广应用。