[1]刘 克,梅莎莎,郭 壮,等.羟考酮或奥赛利定在老年患者内镜逆行胰胆管造影术中应用效果[J].介入放射学杂志,2025,34(10):1089-1093.[doi:10.3969/j.issn.1008-794X.2025.10.009]
　LIU Ke,MEI Shasha,GUO Zhuang,et al.The effect of oxycodone or oliceridine for sedation during endoscopic retrograde cholangiopancreatography in elderly patients[J].J Intervent Med,2025,34(10):1089-1093.[doi:10.3969/j.issn.1008-794X.2025.10.009]
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羟考酮或奥赛利定在老年患者内镜逆行胰胆管造影术中应用效果()

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《介入放射学杂志》[ISSN:1008-794X/CN:31-1796/R]

卷:
34
期数:
2025年10
页码:
1089-1093
栏目:
非血管介入
出版日期:
2025-10-25

文章信息/Info

Title:
The effect of oxycodone or oliceridine for sedation during endoscopic retrograde cholangiopancreatography in elderly patients
文章编号:
1008-794X(2025)-010-1089-05
作者:
刘 克;  梅莎莎;  郭 壮;  徐伟民;  叶文学
257000 山东东营 胜利油田中心医院麻醉科
Author(s):
LIU Ke; MEI Shasha; GUO Zhuang; XU Weimin; YE Wenxue.
Department of Anesthesiology,Shengli Oilfield Central Hospital,Dongying,Shandong Province 257000,China
关键词:
奥赛利定;  内镜逆行胰胆管造影术;  老年人
DOI:
10.3969/j.issn.1008-794X.2025.10.009
文献标志码:
A
摘要:
目的 观察羟考酮或奥赛利定复合丙泊酚静脉麻醉在老年患者内镜逆行胰胆管造影术(endoscopic retrograde cholangiopancreatography,ERCP)中的应用效果。方法 选取2024年3月至9月胜利油田中心医院拟行ERCP老年患者60例,随机分为羟考酮组和奥赛利定组,每组30例。分别给予羟考酮或奥赛利定复合丙泊酚静脉麻醉。记录患者术后舒适度评分。记录术中丙泊酚用量和镇痛药物追加次数。记录患者入室即刻(T0)、镇痛后3 min(T1)、麻醉诱导后(T2)、开始检查即刻(T3)、到达十二指肠乳头时(T4)、苏醒时(T5)生命体征。记录手术时间、苏醒时间、内镜医师满意度、患者满意率、麻醉相关不良事件发生率。结果 患者术后舒适度评分比较显示,奥赛利定组显著高于羟考酮组[(7.6±1.9)比(6.6±1.3),t=2.23,P=0.03]。奥赛利定组术中丙泊酚用量与羟考酮组相比显著减少(P<0.05)。与T0相比,T1～T4时两组患者平均动脉压(MAP)、心率(HR)、呼吸频率(RR)明显下降(均P<0.05),组间比较显示T1～T3时羟考酮组下降更明显(均P<0.05); T4时两组MAP、HR出现升高(均P<0.05),羟考酮组明显高于奥赛利定组(均P<0.05)。奥赛利定组T1时血氧饱和度(SpO2)与T0时相比,差异无统计学意义(P>0.05); 其余时点,两组SpO2出现不同程度下降,组内和组间比较差异有统计学意义(均P<0.05)。奥赛利定组患者苏醒时间与羟考酮组相比明显缩短(P<0.05),内镜医师满意度、患者满意率更高(均P<0.05)。奥赛利定组术中不良事件发生率与羟考酮组相比明显减少(P<0.05),苏醒期间两组不良事件发生率比较差异无统计学意义(P>0.05),但奥赛利定组术后恶心呕吐和呼吸抑制明显低于羟考酮组(均P<0.05)。结论 与羟考酮复合丙泊酚相比,奥赛利定复合丙泊酚应用于老年患者ERCP安全可行,不良事件少,满意率高,患者舒适度高。

参考文献/References:

[1] Howell SJ,Absalom AR.Consensus guidelines,Delphi methods,and evidence around anaesthetic technique for endoscopic retrograde cholangiopancreatography[J].Br J Anaesth,2023,131:634-636.
[2]刘 帆,周东旭.艾司氯胺酮联合经鼻高流量湿化氧疗在经十二指肠镜逆行胆胰管造影中的应用[J].介入放射学杂志,2022,31:675-678.
Liu F,Zhou DX.Application of esketamine combined with high-flow nasal cannula oxygen therapy in endoscopic retrograde cholangiopancreatography[J].J Interve Radiol,2022,31:675-678.
[3]倪欢欢,杨玉玲,陈惠裕,等.羟考酮复合右美托咪定用于老年ERCP手术病人的麻醉效果[J].实用老年医学,2021,35:194-196.
Ni HH,Yang YL,Chen HY,et al.Anesthesia effect of hydrochloride combined with dexmedetomidine in elderly patients undergoing ERCP surgery[J].Practical Geriatrics,2021,35:194-196.
[4]Biskupiak J,Oderda G,Brixner D,et al.Gastrointestinal adverse effects associated with the use of intravenous oliceridine compared with intravenous hydromorphone or fentanyl in acute pain management utilizing adjusted indirect treatment comparison methods[J].J Comp Eff Res,2024,13:e230041.
[5]刘 克,徐伟民,林 泉,等.艾司氯胺酮和右美托咪定在小儿增强CT检查中的镇静效果比较[J].中国新药与临床杂志,2021,40:511-514.
Liu K,Xu WM,Lin Q,et al.Comparison of sedation effect of esketamine and dexmedetomide in pediatric patients undergoing enhanced CT examination[J].Chin J New Drugs Clin Rem,2021,40:511-514.
[6]王 志,陆骊工,陈 磊,等.无痛介入——我们仍需做得更多[J].介入放射学杂志,2022,31:949-953.
Wang Z,Lu LG,Chen L,et al.Painless intervention:there are still a lot of things for us to do[J].J Interve Radiol,2022,31:949-953.
[7]Ding G,Wang L,Zhao W,et al.Comparison of the efficacy and safety of ciprofol and propofol for ERCP anesthesia in older patients:a single-center randomized controlled clinical study[J].J Clin Anesth,2024,99:111609.
[8]雷碧波,樊 飞,张明强,等.超声引导下腹横肌平面阻滞联合喉罩通气在原发性肝癌患者加速康复外科中的有效性和安全性[J].介入放射学杂志,2023,32:149-153.
Lei BB,Fan F,Zhang MQ,et al.The effectiveness and safety of ultrasound-guided transversus abdominis plane block combined with laryngeal mask ventilation general anesthesia in enhanced recovery after surgery for patients with primary liver cancer[J].J Interve Radiol,2023,32:149-153.
[9]李其沛,罗 欣,袁玉静,等.右美托咪定和舒芬太尼复合丙泊酚用于老年患者内镜逆行胰胆管造影术深度镇静的比较[J].临床麻醉学杂志,2023,39:1282-1286.
Li QP,Luo X,Yuan YJ,et al.Comparison of dexmedetomidine and sufentanil combined with propofol for deep sedation undergoing endoscopic retrograde cholangiopancreatography in elderly patients[J].J Clin Anesthesiol,2023,39:1282-1286.
[10]薛艳芝,房娟娟,肖 林,等.不同靶浓度丙泊酚用于老年无痛纤维支气管镜检查患者的临床研究[J].中国临床药理学杂志,2024,40:2630-2634.
Xue YZ,Fang JJ,Xiao L,et al.Clinical trial of different target concentrations of propofol in elderly patients undergoing painless fiberoptic bronchoscopy[J].Chinese J Clin Pharmacol,2024,40:2630-2634.
[11]ASGE Standards of Practice Committee,Machicado JD,et al.American Society for Gastrointestinal Endoscopy guideline on the role of endoscopy in the diagnosis and management of solid pancreatic masses:summary and recommendations[J].Gastrointest Endosc,2024,100:786-796.
[12]白清海,张 强,梁亮亮,等.静脉麻醉在无痛内镜诊疗中应用的研究进展[J].麻醉安全与质控,2024,6:295-299.
Bai QH,Zhang Q,Liang LL,et al.Research progress of intravenous anesthesia in painless endoscopic diagnosis and treatment[J].Periop Saf Qual Assur,2024,6:295-299.
[13]Aggarwal AK.Emerging field of biased opioid agonists[J].Anesthesiol Clin,2023,41:317-328.
[14]Goudra B.Oliceridine-opioid of the 21(st)century[J].Saudi J Anaesth,2022,16:69-75.
(收稿日期:2025-02-04)
(本文编辑:谷 珂)

备注/Memo

备注/Memo:
基金项目: 白求恩公益基金会项目(ezmz2023-066),吴阶平医学基金会临床科研专项项目(320.6750.2024-05-18)
通信作者: 叶文学 E-mail:yewenxuehaha@163.com
更新日期/Last Update: 2025-10-25