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用于基于镇静的胃肠内镜检查的阿片类镇痛药。

Opioid analgesics for sedation-based gastrointestinal endoscopy.

作者信息

Yang Wei-Lin, Zhou Xin-Yu, Jiang Wen-Cai, Zhang Xian-Jie, Zhou Dan

机构信息

Department of Anesthesiology, Deyang People's Hospital, Deyang 618000, Sichuan Province, China.

Graduate School, Chengdu University of Traditional Chinese Medicine, Chengdu 611137, Sichuan Province, China.

出版信息

World J Gastrointest Pharmacol Ther. 2025 Jun 5;16(2):102098. doi: 10.4292/wjgpt.v16.i2.102098.

Abstract

Gastrointestinal endoscopy is a common examination for digestive system. The stimulation of endoscope often causes cough, nausea and vomiting, increased heart rate and blood pressure, arrhythmia, and even cardiovascular and cerebrovascular accidents, thus makes people fear of this procedure. Sedation or anesthesia can effectively improve the safety, comfort and quality of gastrointestinal endoscopy. A small dose of opioids is a good adjuvant to sedatives. In this narrative review, we summarized the main roles of opioid analgesics in gastrointestinal endoscopy, including reducing visceral pain, throat irritation and the dose of sedatives. Moreover, the frequently used and novel opioids are reviewed. Classic fentanyl, sufentanil and dezocine are preferable by anesthesiologists. Newly approved oliceridine is promising to render ideal analgesic effects for gastrointestinal endoscopy. Clinical studies on oliceridine in endoscopic procedures are urgently needed.

摘要

胃肠内镜检查是消化系统常见的检查方法。内镜的刺激常引起咳嗽、恶心、呕吐、心率和血压升高、心律失常,甚至发生心脑血管意外,因此人们对该检查存在恐惧心理。镇静或麻醉可有效提高胃肠内镜检查的安全性、舒适性和质量。小剂量阿片类药物是镇静剂的良好辅助药物。在这篇叙述性综述中,我们总结了阿片类镇痛药在胃肠内镜检查中的主要作用,包括减轻内脏疼痛、咽喉刺激以及减少镇静剂用量。此外,还对常用和新型阿片类药物进行了综述。麻醉医生更倾向于使用经典的芬太尼、舒芬太尼和地佐辛。新批准的oliceridine有望为胃肠内镜检查带来理想的镇痛效果。迫切需要开展oliceridine在内镜检查中的临床研究。

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