埃斯凯特胺与苏芬坦尼尔作为无痛胃肠内镜期间镇静止痛药:双盲随机对照试验
Ting-Ting Li1,2, Xiao-Lan He1,3, Hai-Ling Tang2
1Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, China.
素与米达佐拉姆和普罗波结合,为内镜提供无阿片类药物镇静作用,显著降低低血压和缺氧. 需要进一步的研究来缓解与此疗法相关的分泌量增加和咳.
科学领域:
- 麻醉学 麻醉学
- 胃肠病学 胃肠病学
- 临床药理学 临床药理学
背景情况:
- 无痛的胃肠内镜检查通常涉及缺氧和低血压的风险.
- 埃斯凯特胺表现出同情心和呼吸道保护作用.
- 结合埃斯基他胺与米达佐拉姆和普罗波可以减轻这些不良事件.
研究的目的:
- 评估在无痛胃肠内镜检查中使用埃斯基坦胺,米达佐拉姆和普罗波的疗效和安全性.
- 为了比较埃斯基坦胺和苏芬坦尼尔治疗方案之间的低血压和缺氧的发生率.
- 探索一种无阿片类药物镇静策略的潜力.
主要方法:
- 一项随机对照试验,涉及318名接受无痛胃肠内镜检查的患者.
- 患者被分配给接受sufentanil或esketamine,以及midazolam和propofol. 患者被分配给接受sufentanil或esketamine,以及midazolam和propofol.
- 低血压和缺氧的发生率 (SpO2 <93%) 是主要的结局指标.
主要成果:
- 与sufentanil组相比,埃斯基坦胺组的低血压率 (12.8%与36.2%) 和缺氧率 (7.1%与16.1%) 显著降低.
- 呼吸抑郁症 (呼吸暂停>30s) 在乙胺组也减少 (2.1%对15.4%).
- 然而,乙胺疗法与咳和分泌量增加有关.
结论:
- 乙胺,米达佐拉姆和普罗波为胃肠内镜提供有效的无阿片类药物镇静,减少低血压和缺氧.
- 这种治疗方案为基于阿片类药物的镇静提供了一个有希望的替代方案.
- 需要优化剂量,以尽量减少咳和分泌量增加等副作用.
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