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镇痛在消化道病变识别与治疗中的作用:一项随机、前瞻性、双盲研究

The Role of Analgesia in the Identification and Treatment of Digestive Tract Lesions: A Randomized, Prospective, Double-Blind Study.

作者信息

Popa-Ion Denisa-Ancuța, Chiuțu Luminița Cristina, Denicu Mădălina Maria, Gheonea Dan-Ionuț

机构信息

Resident physician, PhD student, University of Medicine and Pharmacy of Craiova, Romania.

Department of Anesthesia and Intensive Care, Faculty of Medicine, University of Medicine and Pharmacy of Craiova, Romania.

出版信息

Curr Health Sci J. 2023 Jan-Mar;49(1):19-27. doi: 10.12865/CHSJ.49.01.19. Epub 2023 Mar 31.

Abstract

The association of sedation with analgesia in endoscopic procedures represents the ideal combination of anesthetic drugs, which allows these exploratory procedures to be carried out safely, in an outpatient setting. The aim of this study is to compare the results of the use of simple Propofol or Propofol associated with Fentanyl in order to ensure optimal sedation necessary for the detection of benign or malignant lesions of the digestive tract. In this study, 80 patients aged between 18 and 80 years were included, 40 in Group 1 who were administered Propofol alone and 40 in Group 2 in which Propofol was administered associated with Fentanyl. The onset of anesthetic sleep was 19.3±5.1 seconds in Lot 2 versus 29.6±9.1 seconds in Lot 1. The average dose of Propofol used was 203.6±82.8 mg in Lot 1 and in Lot 2 it was lower, 166.3±8.3mg. Cardio respiratory changes were more frequent in Lot 2. The wake-up time was 3.2±1.2 minutes in Lot 1 as a result of the administration of Propofol alone and 7±1.4 minutes in Lot 2. The discharge time was equal for patients in both groups. The degree of postanesthesia safisfaction was 10 for all patients from Lot 2, due to the analgesia provided by the administration of Fentanyl. The use of Propofol associated with Fentanyl in gastrointestinal endoscopic procedures is associated with a rapid recovery of cognitive function at the time of discharge and minimal adverse events, ensuring optimal conditions of analgesia and stability of vital functions.

摘要

在内镜检查过程中,镇静与镇痛相结合是理想的麻醉药物组合,可使这些探查性操作在门诊环境中安全进行。本研究的目的是比较单纯使用丙泊酚或丙泊酚联合芬太尼的效果,以确保对消化道良性或恶性病变进行检测所需的最佳镇静效果。在本研究中,纳入了80例年龄在18至80岁之间的患者,第1组40例,仅给予丙泊酚;第2组40例,丙泊酚与芬太尼联合使用。第2组麻醉睡眠的起效时间为19.3±5.1秒,而第1组为29.6±9.1秒。第1组丙泊酚的平均使用剂量为203.6±82.8毫克,第2组较低,为166.3±8.3毫克。第2组的心肺变化更频繁。由于仅使用丙泊酚,第1组的苏醒时间为3.2±1.2分钟,第2组为7±1.4分钟。两组患者的出院时间相同。由于芬太尼给药提供了镇痛作用,第2组所有患者的麻醉后满意度均为10分。在胃肠道内镜检查中,丙泊酚与芬太尼联合使用与出院时认知功能的快速恢复和最少的不良事件相关,确保了最佳的镇痛条件和生命功能的稳定性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/14fd/10541072/90b18d0707fc/CHSJ-49-01-19-fig1.jpg

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