Application of esketamine combined with butorphanol in painless gastroenteroscopy for elderly patients with obesity
- VernacularTitle:艾司氯胺酮复合布托啡诺在老年肥胖患者无痛胃肠镜检查中的应用研究
- Author:
Ruijing ZHAN
1
;
Huatang ZHAO
;
Xiaojing YUN
;
Yan JIN
;
Ji LI
Author Information
- Publication Type:Journal Article
- Keywords: esketamine; butorphanol; elderly; obesity; painless gastroenteroscopy
- From: China Journal of Endoscopy 2025;31(3):28-36
- CountryChina
- Language:Chinese
- Abstract: Objective To explore the effect of esketamine combined with butorphanol on hemodynamics in painless gastroenteroscopy for elderly patients with obesity and the anesthetic efficacy and safety of this combined anesthesia regimen.Methods The subjects of this study,124 elderly patients with obesity who received painless gastroenteroscopy from January 2022 to March 2024,were randomly divided into two groups,each with 62 cases.Both groups were administrated with propofol 1.50 mg/kg for anesthesia induction.The observation group was given esketamine 0.20 mg/kg combined with butorphanol 10 μg/kg intravenously prior to propofol injection,while the control group was given saline of the same volume as esketamine combined with butorphanol 10 μg/kg intravenously before propofol injection.Vital signs indicators[mean arterial pressure(MAP),heart rate(HR),and percutaneous arterial oxygen saturation(SpO2)]were compared between the two groups at the time of entry(T0),immediately after anesthesia induction(T1),immediately after gastroscopy placement(T2),immediately upon completion of gastroscopy(T3),immediately after colonoscopy insertion(T4),and immediately upon completion of colonoscopy examination(T5).The anesthesia effect was evaluated for the two groups during painless gastroenteroscopy examination.The duration of gastroenteroscopy and propofol dosage were compared between the two groups as well.Visual analogue scale(VAS)score was used to evaluate the postoperative pain level for patients from the two groups 1,2,3,and 4 h after surgery.Intraoperative and postoperative adverse reactions in two groups were recorded.Results The MAP at T3,T4,and T5 time points in observation group were lower than that at T0 time point,the HR at T4 and T5 time point in observation group was lower than that at T0 time point,the differences were statistically significant(P＜0.05),there was no significant difference in SpO2 at each time point in observation group(P＞0.05).While the MAP,HR,and SpO2 at T1,T2,T3,T4,and T5 time points in control group were significantly lower than those at T0 time points,the differences were statistically significant(P＜0.05).The MAP,HR,and SpO2 at T1,T2,T3,T4,and T5 time points in control group were lower than those in observation group,the differences were statistically significant(P＜0.05).The excellent and good rate of anesthesia in observation group was better than that in control group,the difference was statistically significant(P＜0.05).The propofol dosage in observation group was less than that in control group,the recovery time in observation group was shorter than that in control group,the differences were statistically significant(P＜0.05).There were no significant differences in duration of gastroenteroscopy examination,postanesthesia care unit(PACU)stay and leave hospital time between the two groups(P＞0.05).1,2,3,and 4 h postoperative pain VAS scores in observation group were less than those in control group,the differences were statistically significant(P＜0.05).The incidence of respiratory depression was 3.23％,which was significantly lower than 19.35％in control group,the incidence of hypotension was 4.84％,which was significantly lower than 25.81％in control group,the incidence of bradycardia was 0.00％,which was significantly lower than 17.74％in control group,the incidence of nausea and vomiting was 1.61％,which was significantly lower than 12.90％in control group,the differences were statistically significant(P＜0.05).There were no significant differences in the incidence of tachycardia,coughing,body movement,and dizziness between the two groups(P＞0.05).Conclusion Application of esketamine combined with butorphanol in painless gastroenteroscopy for elderly patients with obesity can effectively improve sedative and analgesic effects,stabilize hemodynamics,and reduce adverse reactions.It is worthy clinical application.
