Zhang Peng, Zhang Jin, Zhao Ying, Chen Jun, Wang Shaolin
Department of Anesthesiology, the Second People's Hospital of Wuhu, Wuhu, Anhui, 241000, People's Republic of China.
Local Reg Anesth. 2025 Mar 28;18:1-8. doi: 10.2147/LRA.S505804. eCollection 2025.
While propofol is a commonly utilized medication for sedation during gastrointestinal endoscopy, it is associated with adverse effects such as hypotension and injection pain. This trial was conducted to test the hypothesis that chloroprocaine can reduce the requirement for propofol and alleviate injection pain during gastrointestinal endoscopy.
Sixty patients undergoing gastrointestinal endoscopy were enrolled and randomly divided into study group (Group CP) and control group (Group C). Patients in Group CP received intravenous chloroprocaine 2 mg/kg, followed by continuous infusion at 6 mg·kg·h until the end of examination. Patients in Group C received the same volume of saline. Subsequently, all patients were intravenously administered sufentanil at a dose of 0.05 μg/kg. Thirty seconds later, propofol was uniformly infused intravenously at a rate of 60 mL/min using an infusion pump. The primary outcome was the consumption of propofol. Secondary outcomes included the incidence of hypoxemia, hypotension, bradycardia, injection pain, and coughing/body movement during examination. The recovery time, PACU stay time, postoperative pain score, and endoscopists' satisfaction score were also recorded.
Group CP demonstrated a significantly lower total requirement for propofol compared to Group C, with means of (119±14) mg and (148±18) mg respectively, P<0.001. This trend was also observed for both the first and supplemental doses. There were no significant differences between the two groups regarding intraoperative adverse events. The incidence of injection pain in Group CP was lower than that in Group C (P=0.007). The recovery time [(4.7±1.4) vs (6.6±1.3), P<0.001], PACU stay time [(13.0±2.9) vs (16.7±3.0), P<0.001] and postoperative pain score [(1.9±0.7) vs (2.5±0.7), P=0.002] in Group CP were lower than those in Group C.
Intravenous chloroprocaine reduces the requirement for propofol, alleviates propofol injection pain, and improves recovery in patients undergoing gastrointestinal endoscopy.
虽然丙泊酚是胃肠内镜检查期间常用的镇静药物，但它会引发诸如低血压和注射痛等不良反应。进行该试验是为了验证如下假设：氯普鲁卡因可减少胃肠内镜检查期间丙泊酚的用量并减轻注射痛。
纳入60例接受胃肠内镜检查的患者，并随机分为研究组（CP组）和对照组（C组）。CP组患者静脉注射氯普鲁卡因2mg/kg，随后以6mg·kg·h的速度持续输注直至检查结束。C组患者输注相同体积的生理盐水。随后，所有患者均静脉注射舒芬太尼，剂量为0.05μg/kg。30秒后，使用输液泵以60mL/min的速度匀速静脉输注丙泊酚。主要观察指标为丙泊酚的用量。次要观察指标包括低氧血症、低血压、心动过缓、注射痛以及检查期间咳嗽/身体移动的发生率。还记录了苏醒时间、在麻醉后护理单元（PACU）的停留时间、术后疼痛评分以及内镜医师满意度评分。
与C组相比，CP组丙泊酚的总用量显著更低，分别为（119±14）mg和（148±18）mg，P<0.001。首次剂量和追加剂量均呈现这一趋势。两组术中不良事件无显著差异。CP组注射痛的发生率低于C组（P=0.007）。CP组的苏醒时间[（4.7±1.4）对（6.6±1.3），P<0.001]、在PACU的停留时间[（13.0±2.9）对（16.7±3.），P<0.001]以及术后疼痛评分[（1.9±0.7）对（2.5±0.7），P=0.002]均低于C组。
静脉注射氯普鲁卡因可减少胃肠内镜检查患者丙泊酚的用量，减轻丙泊酚注射痛，并改善恢复情况。
