2022 年第 12 期 第 17 卷

预先输注间羟胺联合超声指导容量补充对行无痛肠镜老年患者血流动力学的影响

Effect of pre-injection metaraminol combined with ultrasound-guided volume supplement in elderly patients with painless colonoscopy

作者：周丹 宋晓阳 程鹏飞 汪宏 黎笔熙

英文作者：Zhou Dan Song Xiaoyang Cheng Pengfei Wang Hong Li Bixi

单位：中部战区总医院麻醉科，武汉430070

英文单位：Department of Anesthesia， General Hospital of Central Theater Command Wuhan 430070 China

关键词：无痛肠镜；间羟胺；超声指导；容量补充

英文关键词：Painlesscolonoscopy;Metaraminol;Ultrasound-guidance;Volumesupplement

• 摘要：

• 目的  探讨预先输注间羟胺联合超声指导容量补充对行无痛肠镜老年患者血流动力学的影响。方法  选取中部战区总医院2021年1—6月行无痛肠镜检查的180例患者为研究对象。按照随机数字表法将患者分为经验性输液组（A组）、超声指导输液组（B组）和超声指导输液+间羟胺组（C组），各60例。A组麻醉前予经验性输液并在麻醉诱导同时静脉给予同等容量0.9%氯化钠注射液，B组麻醉前予超声指导容量补充并在麻醉诱导同时静脉给予同等容量0.9%氯化钠注射液，C组麻醉前予超声指导容量补充并在麻醉诱导同时静脉给予间羟胺2 μg/kg。比较3组患者围术期生命体征、输液量、麻醉药物用量、检查时间、麻醉完全恢复时间、不良反应及满意度。结果  3组麻醉诱导后3 min、检查开始前、检查开始后3 min收缩压及舒张压比较差异均有统计学意义，C组均高于A组（均P＜0.05）。B组、C组检查前输液量、输液总量均多于A组，麻醉完全恢复时间均短于A组［（55±9）、（53±8）min比（76±14）min］，差异均有统计学意义（均P<0.05）。3组麻醉药物用量、检查时间比较差异均无统计学意义（均P>0.05）。B组、C组口渴、恶心呕吐、嗜睡、饥饿、疲劳、头晕发生率均低于A组，且C组恶心呕吐发生率低于B组，差异均有统计学意义（均P＜0.05）。B组、C组患者满意比例高于A组，且C组高于B组，差异均有统计学意义（均P＜0.05）。结论  预先输注间羟胺联合超声指导容量补充可以使老年患者在无痛肠镜检查中血流动力学更加平稳，缩短麻醉完全恢复时间，降低不良反应发生率，提高患者满意度。

• Objective  To explore the effect of pre-injection metaraminol combined with ultrasound-guided volume supplement in elderly patients with painless colonoscopy. Methods  Totally 180 elderly patients with painless colonoscopy were selected in General Hospital of Central Theater Command from January to June 2021. Patients were divided into empirical infusion group (group A), ultrasound-guided infusion group (group B) and ultrasound-guided infusion + metaraminol group (group C) according to the random number table method, with 60 cases in each group. Group A received empirical infusion before anesthesia, and the same dose of 0.9% sodium chloride injection was given intravenously at the same time of anesthesia induction. Group B received ultrasound-guided infusion before anesthesia, and the same dose of 0.9% sodium chloride injection was given intravenously at the same time of anesthesia induction. Group C received ultrasound-guided infusion before anesthesia, and metaraminol 2 μg/kg was given intravenously at the same time of anesthesia induction. Perioperative vital signs, amount of infusion, dosage of anaesthetics, operation time, anesthesia recovery time, adverse effects, and satisfaction were compared among the three groups. Results  There were significant differences in systolic and diastolic blood pressure among the three groups at 3 min after anesthesia induction, before operation and 3 min after the beginning of operation, and systolic and diastolic blood pressure in group C were higher than those in gorup A (all P<0.05). The infusion volume before operation and total infusion volume in group B and group C were higher than those in group A, and anesthesia recovery time was shorter than that in group A ［（55±9）,（53±8）min vs （76±14）min］ (all P<0.05). There were no significant differences in dosage of anaesthetics and operation time among the three groups (all P>0.05). Incidences of thirst, nausea and vomiting, sleepiness, hunger, fatigue and dizziness in group B and group C were lower than those in group A, and the incidence of nausea and vomiting in group C was lower than that in group B (all P<0.05). The rate of satisfaction in group B and group C was higher than that in group A, and that in group C was higher than that in group B (all P<0.05). Conclusion  Pre-injection metaraminol combined with ultrasound-guided volume supplement can make the hemodynamics stable in elderly patients undergoing painless enteroscopy, shorten the anesthesia recovery time, reduce the incidencen of adverse reactions, and improve patients′ satisfaction.