亚麻醉剂量艾司氯胺酮联合应用丙泊酚对老年无痛肠镜检查患者苏醒质量及促炎因子的影响

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Abstract Objective To investigate the effect of subanesthetic dose of esketamine combined with propofol on the recovery quality and pro-inflammatory factors in elderly patients with outpatient colonoscopy. Methods 200 cases of elderly patients with outpatient colonoscopy in our endoscopic center were randomly divided into control group (propofol group) and observation group (subanesthetic dose of esketamine combined with propofol), each were 100 cases. The bispectral index (BIS) was used as an monitoring index of individualized anesthesia depth. The hemodynamic index (HR、RR、MAP、SpO₂) and BIS value of two groups were compared at the time of entering the examine-room (T0), immediately before inserting (T1), the colonoscope has passed the splenic flexion (T2), the colonoscope has passed the liver flexion (T3), colonoscopy end-point (T4) and after procedure (T5). The dosage of propofol, eye-opening time, completion time of commanded action, leaving PACU time, colonoscopy time, 40-item questionnaire (QoR-40) score and adverse reactions of two groups were recorded. The pro-inflammatory factors (IL-1β、IL-6, TNF-α) were compared before and after colonoscopy. Results There were no significant difference in HR, RR, MAP and SpO₂ between two groups at T0. Compared with T0, MAP, SpO₂ and HR of two groups decreased at T1-T4. MAP and SpO₂ in observation group were higher than control group at T1-T4. There was no significant difference in BIS value between two groups at T0-T5. The dosage of propofol of observation group was less than control group. The eye-opening time, completion time of commanded action, leaving PACU time and colonoscopy time had no significant difference between two groups. At T5, the QoR-40 score of physical comfort, pain, emotional state, psychological support and total score of observation group were higher than control group, and the level of IL-1β、IL-6, TNF-αof observation group were lower than control group. The incidence of adverse reactions such as hypotension, respiratory depression, somatic reaction and propofol injection pain of observation group were lower than control group. Conclusion Subanesthetic dose of esketamine combined with propofol can provide effective sedation and analgesia for elderly patients with outpatient colonoscopy. The hemodynamics was stable. It can effectively reduce the level of inflammation, improve quality of early awakening with lower respiratory depression.

Key words： subanesthetic dose esketamine colonoscopy pro-inflammatory factors

Received: 21 March 2023

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	Articles by authors
	LIU Huimin
	FU Weidong
	LUO Liu
	ZHENG Mingzhi

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LIU Huimin,FU Weidong,LUO Liu等. Effect of subanesthetic dose of esketamine combined with propofol on the recovery quality and pro-inflammatory factors in elderly patients with outpatient colonoscopy[J]. HuNan ShiFan DaXue XueBao(YiXueBan), 2023, 20(5): 111-116.

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http://yxb.hunnu.edu.cn/EN/ OR http://yxb.hunnu.edu.cn/EN/Y2023/V20/I5/111

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