奥赛利定复合丙泊酚对老年无痛胃镜检查患者麻醉效果及苏醒质量的影响

doi:10.3877/cma.j.issn.2095-2015.2026.04.013

目的

探究奥赛利定复合丙泊酚对老年无痛胃镜检查患者麻醉效果及苏醒质量的影响。

方法

前瞻性选取2024年12月至2025年5月徐州市第一人民医院就诊的108例老年无痛胃镜检查患者作为研究对象，按随机数表法将其分为观察组（奥赛利定复合丙泊酚麻醉组）和对照组（单纯丙泊酚麻醉组）各54例。记录比较两组患者麻醉诱导前（T₁）、麻醉诱导后（T₂）、胃镜置入时（T₃）、胃镜到达十二指肠球部时（T₄）、胃镜拔除时（T₅）的心率、平均动脉压（MAP）、血氧饱和度（SpO₂）；比较两组患者麻醉效果，包括镇静/麻醉成功率、体动反应发生率、丙泊酚总用量；记录两组苏醒及离开麻醉复苏室（PACU）时间、术后谵妄/躁动发生率，评估苏醒质量；记录胃镜检查及术后24 h内两组患者的不良反应情况。

结果

与T₁时比较，两组T₂、T₃、T₄、T₅的心率、MAP均降低（P<0.05）；观察组T₃时的心率高于对照组；观察组T₅时的MAP高于对照组（P<0.05）；观察组T₂时的SpO₂高于对照组（P<0.05）。观察组体动反应发生率、丙泊酚总用量低于对照组（P<0.05），两组镇静/麻醉成功率比较无明显差异（P>0.05）。观察组苏醒时间、离开PACU时间、术后谵妄/躁动发生率低于对照组，差异有统计学意义（P<0.05）。观察组低氧血症、呼吸抑制、恶心呕吐、腹痛等不良反应发生率低于对照组（P<0.05）。

结论

奥赛利定复合丙泊酚在老年无痛胃镜检查中具有良好的麻醉效果和苏醒质量，提供有效镇痛的同时，呼吸抑制和恶心呕吐风险更低。

关键词: 胃镜检查术, 奥赛利定, 丙泊酚, 麻醉效果, 苏醒质量

Objective

To explore the influence of oliceridine combined with propofol on the anesthetic effect and recovery quality of elderly patients undergoing painless gastroscopy.

Methods

A total of 108 elderly patients who underwent painless gastroscopy at Xuzhou First People's Hospital from December 2024 to May 2025 were prospectively selected as the research subjects. They were randomly divided into the observation group (oliceridine combined with propofol anesthesia group) and the control group (propofol anesthesia alone group), with 54 cases in each group according to the random number table method. The heart rate, mean arterial pressure (MAP), and blood oxygen saturation (SpO₂) of two groups of patients before anesthesia induction (T₁), after anesthesia induction (T₂), during gastroscopy insertion (T₃), when gastroscopy reached the duodenal bulb (T₄), and during gastroscopy removal (T₅) were recorded and compared. The anesthesia effects of two groups of patients, including sedation/anesthesia success rate, incidence of motor reactions, and total dose of propofol were compared. The time of awakening and leaving the post-anesthesia care unit (PACU) for two groups, the incidence of postoperative delirium/ agitation were recorded, and the quality of awakening were evaluated. The adverse reactions of both groups of patients during gastroscopy examination and within 24 hours after surgery were recorded.

Results

Compared with T₁, the HR and MAP of T₂, T₃, T₄ and T₅ in both groups decreased (P<0.05); the HR of the observation group at T₃ was higher than that of the control group (P<0.05); the MAP of the observation group at T₅ was higher than that of the control group (P<0.05); the SpO₂ of the observation group at T₂ was higher than that of the control group (P<0.05). The incidence of body movement reaction and the total dosage of propofol in the observation group were lower than those in the control group (P<0.05), while there was no significant difference in the success rate of sedation/anesthesia between the two groups (P>0.05). The recovery time, departure time from PACU, and incidence of postoperative delirium/restlessness in the observation group were lower than those in the control group, with statistically significant difference (P<0.05). The incidence of adverse reactions such as hypoxemia, respiratory depression, nausea and vomiting, and abdominal pain in the observation group was lower than those in the control group (P<0.05).

Conclusion

Oliceridine combined with propofol has a good anesthetic effect and recovery quality in painless gastroscopy for the elderly. While providing effective analgesia, it has a lower risk of respiratory depression and nausea and vomiting.

Key words: Gastroscopy, Oliceridine, Propofol, Anesthetic effect, Recovery quality

表1 两组胃镜检查患者基线资料对比

组别	例数	性别[例(%)]		年龄(岁,±s)	体重指数(kg/m²,±s)	美国麻醉医师协会分级[例(%)]			合并症[例(%)]			胃镜检查时间(min,±s)
组别	例数	男	女	年龄(岁,±s)	体重指数(kg/m²,±s)	Ⅰ	Ⅱ	Ⅲ	高血压	糖尿病	冠心病	胃镜检查时间(min,±s)
观察组	54	30(55.56)	24(44.44)	68.52±4.37	23.15±2.64	20(37.04)	24(44.44)	10(18.52)	18(33.33)	12(22.22)	12(22.22)	8.22±1.45
对照组	54	32(59.26)	22(40.74)	67.89±4.85	23.42±2.73	22(40.74)	22(40.74)	10(18.52)	20(37.04)	16(29.63)	18(33.33)	8.12±1.53
t/χ²值		0.148		0.502	0.378	0.150			0.148	0.815	1.629	0.252
P值		0.786		0.618	0.707	0.963			0.786	0.366	0.202	0.802

表1 两组胃镜检查患者基线资料对比

组别	例数	性别[例(%)]		年龄(岁,±s)	体重指数(kg/m²,±s)	美国麻醉医师协会分级[例(%)]			合并症[例(%)]			胃镜检查时间(min,±s)
组别	例数	男	女	年龄(岁,±s)	体重指数(kg/m²,±s)	Ⅰ	Ⅱ	Ⅲ	高血压	糖尿病	冠心病	胃镜检查时间(min,±s)
观察组	54	30(55.56)	24(44.44)	68.52±4.37	23.15±2.64	20(37.04)	24(44.44)	10(18.52)	18(33.33)	12(22.22)	12(22.22)	8.22±1.45
对照组	54	32(59.26)	22(40.74)	67.89±4.85	23.42±2.73	22(40.74)	22(40.74)	10(18.52)	20(37.04)	16(29.63)	18(33.33)	8.12±1.53
t/χ²值		0.148		0.502	0.378	0.150			0.148	0.815	1.629	0.252
P值		0.786		0.618	0.707	0.963			0.786	0.366	0.202	0.802

表2 两组胃镜检查患者生命体征指标比较（

±s）

组别	例数	心率(次/min)
组别	例数	T₁	T₂	T₃	T₄	T₅
观察组	54	77.85±5.68	71.58±5.77^*	73.56±6.51^*#	74.69±6.32^*	75.71±5.41^*
对照组	54	78.77±6.55	70.32±7.40^*	71.52±5.58^*	73.45±6.64^*	76.72±4.58^*
F_时间/P_时间值		5.632/0.019
F_组间/P_组间值		4.894/0.029
F_交互/P_交互值		4.245/0.042
组别	例数	平均动脉压(mmHg)
组别	例数	T₁	T₂	T₃	T₄	T₅
观察组	54	95.82±7.55	92.55±7.55^*	92.26±5.72^*	92.32±6.56^*	93.77±7.56^*#
对照组	54	94.64±7.57	91.93±6.63^*	90.67±5.50^*	90.72±6.53^*	91.61±5.57^*
F_时间/P_时间值		6.147/0.015
F_组间/P_组间值		7.981/0.006
F_交互/P_交互值		6.015/0.016
组别	例数	血氧饱和度(%)
组别	例数	T₁	T₂	T₃	T₄	T₅
观察组	54	98.91±2.57	97.83±4.58^#	98.57±2.56	98.59±1.73	98.82±1.55
对照组	54	98.71±2.48	95.75±3.59^*	97.71±2.62	98.66±1.54	98.80±1.50
F_时间/P_时间值		15.328/<0.001
F_组间/P_组间值		6.245/0.014
F_交互/P_交互值		6.876/0.010

表2 两组胃镜检查患者生命体征指标比较（

±s）

组别	例数	心率(次/min)
组别	例数	T₁	T₂	T₃	T₄	T₅
观察组	54	77.85±5.68	71.58±5.77^*	73.56±6.51^*#	74.69±6.32^*	75.71±5.41^*
对照组	54	78.77±6.55	70.32±7.40^*	71.52±5.58^*	73.45±6.64^*	76.72±4.58^*
F_时间/P_时间值		5.632/0.019
F_组间/P_组间值		4.894/0.029
F_交互/P_交互值		4.245/0.042
组别	例数	平均动脉压(mmHg)
组别	例数	T₁	T₂	T₃	T₄	T₅
观察组	54	95.82±7.55	92.55±7.55^*	92.26±5.72^*	92.32±6.56^*	93.77±7.56^*#
对照组	54	94.64±7.57	91.93±6.63^*	90.67±5.50^*	90.72±6.53^*	91.61±5.57^*
F_时间/P_时间值		6.147/0.015
F_组间/P_组间值		7.981/0.006
F_交互/P_交互值		6.015/0.016
组别	例数	血氧饱和度(%)
组别	例数	T₁	T₂	T₃	T₄	T₅
观察组	54	98.91±2.57	97.83±4.58^#	98.57±2.56	98.59±1.73	98.82±1.55
对照组	54	98.71±2.48	95.75±3.59^*	97.71±2.62	98.66±1.54	98.80±1.50
F_时间/P_时间值		15.328/<0.001
F_组间/P_组间值		6.245/0.014
F_交互/P_交互值		6.876/0.010

表3 两组胃镜检查患者麻醉效果比较

组别	例数	镇静/麻醉成功率[例(%)]	体动反应发生率[例(%)]	丙泊酚总用量(mg,±s)
观察组	54	52(96.30)	6(11.11)	95.62±12.63
对照组	54	48(88.89)	18(33.33)	145.84±20.26
t/χ²值		1.071	7.714	10.930
P值		0.301	0.005	<0.001

表3 两组胃镜检查患者麻醉效果比较

组别	例数	镇静/麻醉成功率[例(%)]	体动反应发生率[例(%)]	丙泊酚总用量(mg,±s)
观察组	54	52(96.30)	6(11.11)	95.62±12.63
对照组	54	48(88.89)	18(33.33)	145.84±20.26
t/χ²值		1.071	7.714	10.930
P值		0.301	0.005	<0.001

表4 两组胃镜检查患者苏醒质量比较

组别	例数	苏醒时间(min,±s)	离开麻醉复苏室时间(min,±s)	术后谵妄/躁动发生率[例(%)]
观察组	54	5.62±1.55	14.45±2.16	2(3.71)
对照组	54	6.55±1.47	17.34±3.41	12(22.22)
t/χ²值		2.262	3.720	4.103
P值		0.027	<0.001	0.042

表4 两组胃镜检查患者苏醒质量比较

组别	例数	苏醒时间(min,±s)	离开麻醉复苏室时间(min,±s)	术后谵妄/躁动发生率[例(%)]
观察组	54	5.62±1.55	14.45±2.16	2(3.71)
对照组	54	6.55±1.47	17.34±3.41	12(22.22)
t/χ²值		2.262	3.720	4.103
P值		0.027	<0.001	0.042

表5 两组胃镜检查患者不良反应比较[例(%)]

组别	例数	低氧血症	低血压	呼吸抑制	心动过缓	恶心呕吐	腹痛
观察组	54	2(3.70)	6(11.11)	2(3.70)	8(14.81)	4(7.41)	0(0.00)
对照组	54	12(22.22)	10(18.52)	14(25.93)	12(22.22)	16(29.63)	8(14.81)
χ²值		8.206	1.174	10.564	0.982	8.328	8.640
P值		0.004	0.279	0.001	0.322	0.004	0.003

表5 两组胃镜检查患者不良反应比较[例(%)]

组别	例数	低氧血症	低血压	呼吸抑制	心动过缓	恶心呕吐	腹痛
观察组	54	2(3.70)	6(11.11)	2(3.70)	8(14.81)	4(7.41)	0(0.00)
对照组	54	12(22.22)	10(18.52)	14(25.93)	12(22.22)	16(29.63)	8(14.81)
χ²值		8.206	1.174	10.564	0.982	8.328	8.640
P值		0.004	0.279	0.001	0.322	0.004	0.003

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Influence of oliceridine combined with propofol on the anesthetic effect and recovery quality of elderly patients undergoing painless gastroscopy

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Influence of oliceridine combined with propofol on the anesthetic effect and recovery quality of elderly patients undergoing painless gastroscopy