环泊酚与丙泊酚复合小剂量阿芬太尼在胃肠镜检查中的应用

王玉; 冷玉芳; 李东斌; 邢阳; 常利娅; 赵紫岑

doi:10.16016/j.2097-0927.202404123

您当前的位置：

首页 >

文章列表页 >

环泊酚与丙泊酚复合小剂量阿芬太尼在胃肠镜检查中的应用

临床医学 | 更新时间：2026-01-09

- 环泊酚与丙泊酚复合小剂量阿芬太尼在胃肠镜检查中的应用
- Application of cypropofol and propofol combined with low-dose alfentanil in gastroenteroscopy
- 陆军军医大学学报 2024年46卷第23期页码：2642-2648
- 作者机构：
  
  1.730000 兰州，兰州大学第一临床医学院
  2.730000 兰州，兰州大学第一医院麻醉手术科
- 作者简介：
  
  [ 冷玉芳，E-mail: lengyf@lzu.edu.cnLENG Yufang, E-mail: lengyf@lzu.edu.cn
- 基金信息：
  
  兰州大学医学教育创新发展项目(lzuyxcx-2022-108)
- DOI：10.16016/j.2097-0927.202404123
  中图分类号： R573;R614.2;R971.2
- 收稿：2024-04-26，
  
  修回：2024-08-01，
  
  纸质出版：2024-12-15
- 稿件说明：
移动端阅览
王玉, 冷玉芳, 李东斌, 等. 环泊酚与丙泊酚复合小剂量阿芬太尼在胃肠镜检查中的应用[J]. 陆军军医大学学报, 2024,46(23):2642-2648.

Yu WANG, Yufang LENG, Dongbin LI, et al. Application of cypropofol and propofol combined with low-dose alfentanil in gastroenteroscopy[J]. Journal of Army Medical University, 2024, 46(23): 2642-2648.
王玉, 冷玉芳, 李东斌, 等. 环泊酚与丙泊酚复合小剂量阿芬太尼在胃肠镜检查中的应用[J]. 陆军军医大学学报, 2024,46(23):2642-2648. DOI： 10.16016/j.2097-0927.202404123.

Yu WANG, Yufang LENG, Dongbin LI, et al. Application of cypropofol and propofol combined with low-dose alfentanil in gastroenteroscopy[J]. Journal of Army Medical University, 2024, 46(23): 2642-2648. DOI： 10.16016/j.2097-0927.202404123.

摘要

目的

研究环泊酚与丙泊酚分别复合小剂量阿芬太尼用于胃肠镜检查麻醉效果和不良反应。

方法

选择2024年1-2月于兰州大学第一医院消化内镜中心择期行胃肠镜检查的患者162例，男86例，女76例，年龄18~65岁，BMI 18~30 kg/m

ASA≤Ⅱ级。将患者随机分为2组，每组81例：丙泊酚组(P组)和环泊酚组(C组)。所有患者静注阿芬太尼7 μg/kg，30 s后P组静注丙泊酚2 mg/kg、C组静注环泊酚0.4 mg/kg；待患者改良警觉/镇静评分(modified observer’s assessment of alertness/sedation，MOAA/S)≤1分，开始胃镜进镜操作。记录检查时间、镇静成功例数、诱导时间、苏醒时间。记录患者心率、血压、脉搏血氧饱度。记录低血

压、呼吸抑制、注射痛、术中体动、恶心呕吐等不良反应发生情况，及内镜医师和患者对麻醉的满意度。

结果

2组患者镇静成功率、诱导时间、苏醒时间差异均无统计学意义。与P组比较，C组患者术中生命体征更平稳，C组注射痛、呼吸抑制、低血压发生率均明显降低(

＜0.05)，患者对麻醉的满意度明显增高(

＜0.05)，2组内镜医师对麻醉的满意度差异无统计学意义。

结论

复合小剂量阿芬太尼，环泊酚0.4 mg/kg在胃肠镜诊疗中能提供与丙泊酚2 mg/kg相似的镇静效果，诱导和苏醒时间相当；患者术中生命体征更平稳，低血压、呼吸抑制、注射痛等不良反应少，患者满意度高，值得临床推广。

Abstract

Objective

To investigate the anesthetic effects and adverse effects of cypropofol and propofol combined with alfentanil

respectively

for gastroenteroscopy.

Methods

A total of 162 patients who underwent elective gastroenteroscopy at the Gastrointestinal Endoscopy Center of the First Hospital of Lanzhou University from January to February 2024 were enrolled

including 86 males and 76 females

at an age of 18~65 years old

with a BMI value of 18~30 kg/m

and ASA grade ≤Ⅱ. They were randomly divided into propofol group (Group P) and cypropofol group (Group C)

with 81 cases in each group. All patients were sedated with 0.7 μg/kg alfentanil

and in 30 s later

2 mg/kg propofol and 0.4 mg/kg cypropofol was intravenously dripped into Group P and Group C

respectively. When the modified alertness/sedation score (MOAA/S) ≤1

a gastroscope was started to insert. The related indicators

including total procedure time

successful cases of sedation

induction time and awakening time

heart rate

blood pressure

and pulse oximetry saturation were recorded

occurrence of adverse reactions such as hypotension

respiratory depression

injection pain

intraoperative body movement

nausea and vomiting were observed

and the satisfaction of endoscopists and of patients to anesthesia were recorded and compared between the 2 groups.

Results

There were no statistical differences in the success rate of sedation

induction time and awakening time between the 2 groups. The patien

ts of the Group C had more stable intraoperative vital signs

statistically lower incidences of injection pain

respiratory depression and hypotension (

0.05)

and increased satisfaction for anesthesia (

0.05) when compared with those in Group P. No obvious difference were observed in the satisfaction of endoscopist to anesthesia between the 2 groups.

Conclusion

In combination with small-dose alfentanil

0.4 mg/kg cypropofol shows similar sedation effect as 2 mg/kg propofol in gastroenteroscopy

with comparable induction and awakening time. Cypropofol has more advantages in stable intraoperative vital signs

less adverse effects such as low blood pressure

respiratory depression and injection pain

higher the patient satisfaction

which is worthy of clinical promotion.

关键词

Keywords

references

MENG Q T, CAO C, LIU H M, et al . Safety and efficacy ofetomidate and propofol anesthesia in elderly patients undergoing gastroscopy: a double-blind randomized clinical study[J ] . Exp Ther Med, 2016, 12(3): 1515-1524. DOI: 10.3892/etm.2016.3475.

傅俊豪, 陈妍, 杨纯勇, 等. 丙泊酚麻醉下脑氧供需平衡和大脑自动调节平台及其影响因素的研究[J]. 陆军军医大学学报, 2022, 44(18): 1845-1855. DOI: 10.16016/j.2097-0927.202205161.

FU J H, CHEN Y, YANG C Y, et al . Brain oxygen supply-demand balance and cerebral autoregulatory plateau under propofol anesthesia and influencing factors [J ] . J Amry Med Univ, 2022, 44(18): 1845-1855. DOI: 10.16016/j.2097-0927.202205161.

OGAWA T, TOMODA T, KATO H, et al . Propofol sedation with a target-controlled infusion pump in elderly patients undergoing ERCP[J ] . Gastrointest Endosc, 2020, 92(2): 301-307. DOI: 10.1016/j.gie.2020.03.002.

LIU Y, YU X, ZHU D, et al . Safety and efficacy of ciprofol vs. propofol for sedation in intensive care unit patients with mechanical ventilation: a multi-center, open label, randomized, phase 2 trial[J ] . Chin Med J (Engl), 2022, 135(9): 1043-1051. DOI: 10.1097/CM9.0000000000001912.

HSIEH C H, LIN T Y, WANG T Y, et al . The safety and efficacy of alfentanil-based induction in bronchoscopy sedation: a rando mized, double-blind, controlled trial[J ] . Medicine, 2016, 95(43): e5101. DOI: 10.1097/MD.0000000000005101.

XU C, HE L, REN J J, et al . Efficacy and safety of remimazolam besylate combined with alfentanil in painless gastroscopy: a randomized, single-blind, parallel controlled study[J ] . Contrast Media Mol Imaging, 2022, 2022: 7102293. DOI: 10.1155/2022/7102293.

王倩, 王茂华, 杨天爽, 等. 不同剂量瑞马唑仑复合丙泊酚应用于无痛胃镜检查的效果[J]. 临床麻醉学杂志, 2022, 38(2): 163-166. DOI: 10.12089/jca.2022.02.011.

WANG Q, WANG M H, YANG T S, et al . Effect of different doses of remimazolam combined with propofol in painless gastroscopy[J ] . J Clin Anesthesiol, 2022, 38(2): 163-166. DOI: 10.12089/jca.2022.02.011.

易强林, 莫怀忠, 胡慧, 等. 环泊酚与丙泊酚在老年患者无痛胃镜检查中的比较[J]. 临床麻醉学杂志, 2022, 38(7): 712-715. DOI: 10.12089/jca.2022.07.008.

YI Q L, MO H Z, HU H, et al . Comparison of ciprofol and propofol in elderly patients undergoing gastroscopy[J ] . J Clin Anesthesiol, 2022, 38(7): 712-715. DOI: 10.12089/jca.2022.07.008.

GRENDELMEIER P, TAMM M, PFLIMLIN E, et al. Propofol sedation for flexible bronchoscopy: a randomised, noninferiority trial[J ] . Eur Respir J, 2014, 43(2): 591-601. DOI: 10.1 183/09031936.00200412.

刘慧敏, 付卫东, 罗柳, 等. 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[J]. 湖南师范大学学报(医学版), 2023, 20(5): 111-116. DOI: 10.3969/j.issn.1673-016X.2023.05.021.

LIU H M, FU W D, LUO L, et al . Effect of subanesthetic dose of esketamine combined with propofol on the recovery quality and pro-inflammatory factors in elderly patients with outpatient colonoscopy[J ] . J Hunan Norm Univ Med Sci, 2023, 20(5): 111-116. DOI: 10.3969/j.issn.1673-016X.2023.05.021.

王悠笛, 陈亮, 孙盈盈, 等. 环泊酚或丙泊酚复合瑞芬太尼用于无痛纤维支气管镜检查的比较[J]. 临床麻醉学杂志, 2023, 39(10): 1050-1054. DOI: 10.12089/jca.2023.10.008.

WANG Y D, CHEN L, SUN Y Y, et al . Comparison of ciprofol or propofol combined with remifentanil for painless fiberoptic bronchoscopy[J ] . J Clin Anesthesiol, 2023, 39(10): 1050-1054. DOI: 10.12089/jca.2023.10.008.

LI S F, WANG Y, CHEN X J, et al . Effective doses of nalbuphine combined with propofol for painless gastroscopy in adults: a randomized controlled trial[J ] . Front Pharmacol, 2021, 12: 673550. DOI: 10.3389/fphar.2021.673550.

WANG L F, WU Q Y, WANG M, et al . The safety and efficacy of alfentanil combined with midazolam in fiberoptic broncho scopy sedation: a randomized, double-blind, controlled trial[J ] . Front Pharmacol, 2022, 13: 1036840. DOI: 10.3389/fphar.2022.1036840.

高亮, 朱彦侠. 不同剂量阿芬太尼复合丙泊酚在无痛胃镜检查中的应用效果[J]. 临床医学工程, 2023, 30(9): 1193-1194. DOI: 10.3969/j.issn.1674-4659.2023.09.1193.

GAO L, ZHU Y X. Application effect of different doses of alfentanil combined with propofol in painless gastroscopy[J]. Clin Med Eng, 2023, 30(9): 1193-1194. DOI: 10.3969/j.issn.1674-4659.2023.09.1193.

WEI Y, QIU G, LEI B, et al . Oral delivery of propofol with methoxymethylphosphonic acid as the delivery vehicle[J ] . J Med Chem, 2017, 60(20): 8580-8590. DOI: 10.1021/acs.jmedchem.7b01133.

LI X J, YANG D M, LI Q Q, et al . Safety, pharmacokinetics, and pharmacodynamics of a single bolus of the γ-aminobutyric acid (gaba) receptor potentiator HSK3486 in healthy Chinese elderly and Non-elderly[J ] . Front Pharmacol, 2021, 12: 735700. DOI: 10.3389/fphar.2021.735700.

TENG Y, OU M C, WANG X, et al . Pharmacokinetic and pharmacodynamic properties of ciprofol emulsion in Chinese subjects: a single center, open-label, single-arm dose-escalation phase 1 study[J ] . Am J Transl Res, 2021, 13(12): 13791-13802.

"环泊酚临床应用指导意见"专家小组. 环泊酚临床应用指导意见[J]. 中华麻醉学杂志, 2021, 41(2): 4. DOI: 10.3760/cma.j.cn131073.20201011.00201.

Expert Group for Guidelines on Clinical Application of Ciprofol. Guidelines on clinical application of ciprofol[J]. Chin J Anesthesiol, 2021, 41(2): 4. DOI: 10.3760/cma.j.cn131073.20201011.00201.

LIANG P, DAI M, WANG X, et al . Efficacy and safety of ciprofol vs . propofol for the induction and maintenance of general anaesthesia: a multicentre, single-blind, randomised, parallel-group,phase 3 clinical trial[J ] . Eur J Anaesthesiol, 2023, 40(6): 399-406. DOI: 10.1097/EJA.0000000000001799..

LIAO J, LI M T, HUANG C L, et al . Pharmacodynamics and pharmacokinetics of HSK3486, a novel 2, 6-disubstituted phenol derivative as a general anesthetic[J ] . Front Pharmacol, 2022, 13: 830791. DOI: 10.3389/fphar.2022.830791.

LIAO J S, LV S, WANG X, et al . Effect of ciprofol on swallowing function in patients undergoing painless gastrointestinal endoscopy[J ] . Medicine, 2023, 102(35): e34422. DOI: 10.1097/MD.0000000000034422.

梁文波, 任志强, 秦卫民, 等. 不同剂量环泊酚用于无痛胃镜检查的效果[J]. 临床麻醉学杂志, 2023, 39(5): 481-485. DOI: 10.12089/jca.2023.05.006.

LIANG W B, REN Z Q, QIN W M, et al . Effect of different doses of ciprofol inpainless gastroscopy[J ] . J Clin Anesthesiol, 2023, 39(5): 481-485. DOI: 10.12089/jca.2023.05.006.

QIN L L, REN L, WAN S L, et al . Design, synthesis, and evaluation of novel 2, 6-disubstituted phenol derivatives as general anesthetics[J ] . J Med Chem, 2017, 60(9): 3606-3617. DOI: 10.1021/acs.jmedchem.7b00254.

BAKHTIARI E, MOUSAVI S H, GHARAVI FARD M. Pharmacological control of pain during propofol injection: a systematic review and meta-analysis[J]. Expert Rev Clin Pharmacol, 2021, 14(7): 889-899. DOI: 10.1080/17512433.2021.1919084.

JONSSON M M, LINDAHL S G E, ERIKSSON L I. Effect of propofol on carotid body chemosensitivity and cholinergic chemotransduction[J]. Anesthesiology, 2005, 102(1): 110-116. DOI: 10.1097/00000542-200501000-00019.

EBERT T J. Sympathetic and hemodynamic effects of moderate and deep sedation with propofol in humans[J]. Anesthesiology, 2005, 103(1): 20-24. DOI: 10.1097/00000542-200507000-00007.

KANAYA N, GABLE B, WICKLEY P J, et al . Experimental conditions are important determinants of cardiac inotropic effects of propofol[J ] . Anesthesiology, 2005, 103(5): 1026-1034. DOI: 10.1097/00000542-200511000-00017.

高玉蓓, 李寿春, 赵瑞珍, 等. 依托咪酯联合环泊酚全身麻醉对手术患者血流动力学和应激反应的影响[J]. 中国医药导刊, 2023, 25(3): 297-302.

GAO Y B, LI S C, ZHAO R Z, et al . Effects of etomidate combined with ciprofol on hemodynamics and stress response of surgical patients undergoing general anesthesia[J ] . Chin J Med Guide, 2023, 25(3): 297-302.

LI J X, WANG X, LIU J, et al . Comparison of ciprofol (HSK3486) versus propofol for the induction of deep sedation during gastroscopy and colonoscopy procedures: a multi-centre, non-inferiority, randomized, controlled phase 3 clinical trial[J ] . Basic Clin Pharmacol Toxicol, 2022, 131(2): 138-148. DOI: 10.1111/bcpt.13761.

WEN J X, LIU C, DING X Y, et al . Efficacy and safety of ciprofol (HSK3486) for procedural sedation and anesthesia induction in surgical patients: a systematic review and meta-analysis[J ] . Heliyon, 2023, 9(12): e22634. DOI: 10.1016/j.heliyon.2023.e22634.

SAHINOVIC M M, STRUYS M M R F, ABSALOM A R. Clinical pharmacokinetics and pharmacodynamics of propofol[J]. Clin Pharmacokinet, 2018, 57(12): 1539-1558. DOI: 10.1007/s40262-018-0672-3.

浏览量

下载量

CSCD

文章被引用时，请邮件提醒。

提交

工具集

关联资源

Mdivi-1通过抑制过度线粒体自噬改善低氧复合丙泊酚引起的未成熟SD大鼠认知功能障碍

聚核糖性死亡在低氧复合丙泊酚致PC12细胞损伤中的作用

丙泊酚下调TGF-β1抑制乳腺癌细胞迁移和侵袭能力

多功能经颅骨颅内穿刺针持续颅内压监测指导颅脑创伤手术丙泊酚麻醉用量

丙泊酚对新生小鼠下丘脑室旁核神经元及下丘脑小胶质细胞的影响