Objective:To investigate the clinical application effect of ciprofol combined with low-dose esketamine in painless gastrointestinal endoscopy.Methods:A retrospective analysis was conducted on the clinical data of 160 ...Objective:To investigate the clinical application effect of ciprofol combined with low-dose esketamine in painless gastrointestinal endoscopy.Methods:A retrospective analysis was conducted on the clinical data of 160 patients who underwent painless gastrointestinal endoscopy at the Digestive Endoscopy Center of Chengdu Integrated Traditional Chinese and Western Medicine Hospital from June 2023 to June 2024.The patients were divided into a control group(ciprofol+sufentanil,n=80)and a study group(ciprofol+esketamine,n=80)based on the anesthesia protocol they received.Hemodynamic indicators[mean arterial pressure(MAP),heart rate(HR),and blood oxygen saturation(SpO2)],anesthesia-related indicators,sedation effectiveness,and the incidence of adverse events were observed and compared between the two groups at different time points during the examination.Results:The fluctuations in HR and MAP at three time points(after induction,during endoscope insertion,and during the examination)were significantly smaller in the study group than in the control group(all P<0.05),indicating more stable hemodynamics.The total amount of sedative drugs used,the number of additional sedative doses administered,and the time spent in the post-anesthesia care unit were significantly lower in the study group than in the control group(all P<0.05).There was no significant difference in the success rate of sedation between the two groups(98.75%vs.96.25%,P>0.05).The incidence of adverse events was lower in the study group than in the control group(3.75%vs.13.75%,P<0.05).Conclusion:The use of low-dose esketamine as an adjuvant analgesic drug based on ciprofol sedation can effectively maintain hemodynamic stability,reduce the amount of sedative drugs used,facilitate rapid recovery of patients,and lower the risk of adverse events.展开更多
BACKGROUND Elderly patients often display age-related physiological decline,which increases their susceptibility to complications during medical procedures.Therefore,it is clinically imperative to refine anesthetic pr...BACKGROUND Elderly patients often display age-related physiological decline,which increases their susceptibility to complications during medical procedures.Therefore,it is clinically imperative to refine anesthetic protocols for painless gastroscopy in this vulnerable population.AIM To explore the effects of the etomidate-propofol combination on anesthesia quality,compliance,and adverse reactions in elderly patients undergoing painless gastrointestinal endoscopy.METHODS A total of 103 elderly patients scheduled for painless gastrointestinal endoscopy at the Hospital of Wuhan Economic and Technological Development Zone(Hannan District)between October 2022 and October 2024 were enrolled.The participants were divided into a control group(n=50)receiving propofol anesthesia and an observation group(n=53)that received a combination of etomidate and propofol anesthesia.The anesthesia quality(including induction time,recovery time,and orientation recovery time),compliance,hemodynamic parameters(heart rate,oxygen saturation,systolic/diastolic blood pressure),adverse reactions(muscle tremors,injection pain,respiratory depression,hypotension,and nausea/vomiting),and analgesic and sedative effects[evaluated using the visual analog scale(VAS)and Ramsay score]were comparatively analyzed.RESULTS The observation group had significantly shorter anesthesia induction,recovery,and orientation recovery times than the control group.Moreover,the observation group showed higher compliance;greater hemodynamic stability at preanesthesia(T0),during anesthesia(T1),and postrecovery(T2)time points;and a significantly lower incidence of adverse reactions.The VAS and Ramsay scores at 5,30,and 60 minutes after anesthesia recovery were also significantly lower in the observation group than in the control group.CONCLUSION The etomidate-propofol combination for painless gastrointestinal endoscopy in elderly patients may provide superior anesthesia quality and improved compliance and safety,making it a promising approach for clinical application.展开更多
Objective:To analyze the therapeutic effect of high-frequency electrosurgical knife surgery guided by painless digestive endoscopy(PDE)in elderly patients with gastrointestinal polyps(GP).Methods:A total of 100 elderl...Objective:To analyze the therapeutic effect of high-frequency electrosurgical knife surgery guided by painless digestive endoscopy(PDE)in elderly patients with gastrointestinal polyps(GP).Methods:A total of 100 elderly GP patients admitted between June 2021 and December 2022 were selected.Patients were randomly divided into two groups:the painless group(50 cases)underwent high-frequency electrosurgical knife surgery guided by PDE,while the conventional group(50 cases)underwent the same surgery guided by traditional digestive endoscopy(DE).The total treatment efficacy,perioperative indicators,gastrointestinal hormone levels,oxidative stress(OS)markers,and complication rates were compared between the two groups.Results:The total treatment efficacy in the painless group was higher than that in the conventional group,and perioperative indicators were superior in the painless group(P<0.05).One week after treatment,the gastrointestinal hormone levels and OS-related markers in the painless group were better than those in the conventional group(P<0.05).The complication rate in the painless group was lower than in the conventional group(P<0.05).Conclusion:High-frequency electrosurgical knife surgery guided by PDE improves the effectiveness of polyp removal in elderly GP patients and accelerates postoperative recovery.It also protects gastrointestinal function,reduces postoperative OS,and ensures higher surgical safety.展开更多
Objective The popularization of gastroenteroscopy and the introduction of comfortable medical care have further promoted the growth of people's demand,especially the demand for painless endoscopy.This cross-sectio...Objective The popularization of gastroenteroscopy and the introduction of comfortable medical care have further promoted the growth of people's demand,especially the demand for painless endoscopy.This cross-sectional study aims to investigate the current situation and change in county people's demand for endoscopy to promote the development of endoscopy centers in county hospitals in southeast China.Methods From October to December 2021,patients and their family members who came to the Gastroenterology Department in Suichang County People's Hospital of Zhejiang Province were randomly selected to complete the questionnaire.A total of 838 valid questionnaires were collected.Additionally,the original software data of the Endoscopy Center were sampled and retrieved(from October to December every year from 2018 to 2021)for statistical analysis of real-world data.Those who would choose painless endoscopy the next time in the valid questionnaires were included in the painless endoscopy group,while those who would choose ordinary endoscopy the next time were included in the ordinary endoscopy group.Results The stepwise forward binary logistic regression model analysis showed that,patients with“secondhand smoke exposure”were more willing to choose painless endoscopy(OR=1.459,95%CI:1.050-2.028,p=0.025).However,patients with an education level of“primary and below”and“junior high school”,and patients who are suffering from“currently experiencing abdominal distension”,were more willing to choose ordinary endoscopy(OR=0.270,95%CI:0.149-0.488,p<0.001;OR=0.528,95%CI:0.330-0.845,p=0.008;OR=0.536,95%CI:0.334-0.861,p=0.010).Patients with previous experience in painless endoscopy tended to choose painless endoscopy the next time,while patients with previous experience in ordinary endoscopy tended to choose ordinary endoscopy the next time(χ^(2)=140.97,p<0.001).From 2018 to 2021,the proportion of painless endoscopy has increased yearly(p<0.001).Most patients indicated that they would“regularly review gastroenteroscopy”(477/838,56.9%).Conclusions With Suichang County of Zhejiang Province as the representative,the demand for painless endoscopy for people's gastrointestinal cancer detection in southeast China has been increasing yearly.The development of endoscopy centers in county-level hospitals can basically meet the demand growth.Meanwhile,advanced concepts such as comfortable medical care and regular follow-up are gradually popularized at the grassroots level in southeast China.展开更多
基金China Red Cross Foundation Medical Empowerment Special Fund-“Medical Empowerment and Talent Cultivation Program”Clinical Research ProjectProject Title:A Clinical Study on the Use of Esketamine at Different Dosages Combined with Propofol for Painless Gastroscopy(Project No.:GCP-2022-022)。
文摘Objective:To investigate the clinical application effect of ciprofol combined with low-dose esketamine in painless gastrointestinal endoscopy.Methods:A retrospective analysis was conducted on the clinical data of 160 patients who underwent painless gastrointestinal endoscopy at the Digestive Endoscopy Center of Chengdu Integrated Traditional Chinese and Western Medicine Hospital from June 2023 to June 2024.The patients were divided into a control group(ciprofol+sufentanil,n=80)and a study group(ciprofol+esketamine,n=80)based on the anesthesia protocol they received.Hemodynamic indicators[mean arterial pressure(MAP),heart rate(HR),and blood oxygen saturation(SpO2)],anesthesia-related indicators,sedation effectiveness,and the incidence of adverse events were observed and compared between the two groups at different time points during the examination.Results:The fluctuations in HR and MAP at three time points(after induction,during endoscope insertion,and during the examination)were significantly smaller in the study group than in the control group(all P<0.05),indicating more stable hemodynamics.The total amount of sedative drugs used,the number of additional sedative doses administered,and the time spent in the post-anesthesia care unit were significantly lower in the study group than in the control group(all P<0.05).There was no significant difference in the success rate of sedation between the two groups(98.75%vs.96.25%,P>0.05).The incidence of adverse events was lower in the study group than in the control group(3.75%vs.13.75%,P<0.05).Conclusion:The use of low-dose esketamine as an adjuvant analgesic drug based on ciprofol sedation can effectively maintain hemodynamic stability,reduce the amount of sedative drugs used,facilitate rapid recovery of patients,and lower the risk of adverse events.
文摘BACKGROUND Elderly patients often display age-related physiological decline,which increases their susceptibility to complications during medical procedures.Therefore,it is clinically imperative to refine anesthetic protocols for painless gastroscopy in this vulnerable population.AIM To explore the effects of the etomidate-propofol combination on anesthesia quality,compliance,and adverse reactions in elderly patients undergoing painless gastrointestinal endoscopy.METHODS A total of 103 elderly patients scheduled for painless gastrointestinal endoscopy at the Hospital of Wuhan Economic and Technological Development Zone(Hannan District)between October 2022 and October 2024 were enrolled.The participants were divided into a control group(n=50)receiving propofol anesthesia and an observation group(n=53)that received a combination of etomidate and propofol anesthesia.The anesthesia quality(including induction time,recovery time,and orientation recovery time),compliance,hemodynamic parameters(heart rate,oxygen saturation,systolic/diastolic blood pressure),adverse reactions(muscle tremors,injection pain,respiratory depression,hypotension,and nausea/vomiting),and analgesic and sedative effects[evaluated using the visual analog scale(VAS)and Ramsay score]were comparatively analyzed.RESULTS The observation group had significantly shorter anesthesia induction,recovery,and orientation recovery times than the control group.Moreover,the observation group showed higher compliance;greater hemodynamic stability at preanesthesia(T0),during anesthesia(T1),and postrecovery(T2)time points;and a significantly lower incidence of adverse reactions.The VAS and Ramsay scores at 5,30,and 60 minutes after anesthesia recovery were also significantly lower in the observation group than in the control group.CONCLUSION The etomidate-propofol combination for painless gastrointestinal endoscopy in elderly patients may provide superior anesthesia quality and improved compliance and safety,making it a promising approach for clinical application.
文摘Objective:To analyze the therapeutic effect of high-frequency electrosurgical knife surgery guided by painless digestive endoscopy(PDE)in elderly patients with gastrointestinal polyps(GP).Methods:A total of 100 elderly GP patients admitted between June 2021 and December 2022 were selected.Patients were randomly divided into two groups:the painless group(50 cases)underwent high-frequency electrosurgical knife surgery guided by PDE,while the conventional group(50 cases)underwent the same surgery guided by traditional digestive endoscopy(DE).The total treatment efficacy,perioperative indicators,gastrointestinal hormone levels,oxidative stress(OS)markers,and complication rates were compared between the two groups.Results:The total treatment efficacy in the painless group was higher than that in the conventional group,and perioperative indicators were superior in the painless group(P<0.05).One week after treatment,the gastrointestinal hormone levels and OS-related markers in the painless group were better than those in the conventional group(P<0.05).The complication rate in the painless group was lower than in the conventional group(P<0.05).Conclusion:High-frequency electrosurgical knife surgery guided by PDE improves the effectiveness of polyp removal in elderly GP patients and accelerates postoperative recovery.It also protects gastrointestinal function,reduces postoperative OS,and ensures higher surgical safety.
基金supported by the National Natural Science Foundation of China(82073160).
文摘Objective The popularization of gastroenteroscopy and the introduction of comfortable medical care have further promoted the growth of people's demand,especially the demand for painless endoscopy.This cross-sectional study aims to investigate the current situation and change in county people's demand for endoscopy to promote the development of endoscopy centers in county hospitals in southeast China.Methods From October to December 2021,patients and their family members who came to the Gastroenterology Department in Suichang County People's Hospital of Zhejiang Province were randomly selected to complete the questionnaire.A total of 838 valid questionnaires were collected.Additionally,the original software data of the Endoscopy Center were sampled and retrieved(from October to December every year from 2018 to 2021)for statistical analysis of real-world data.Those who would choose painless endoscopy the next time in the valid questionnaires were included in the painless endoscopy group,while those who would choose ordinary endoscopy the next time were included in the ordinary endoscopy group.Results The stepwise forward binary logistic regression model analysis showed that,patients with“secondhand smoke exposure”were more willing to choose painless endoscopy(OR=1.459,95%CI:1.050-2.028,p=0.025).However,patients with an education level of“primary and below”and“junior high school”,and patients who are suffering from“currently experiencing abdominal distension”,were more willing to choose ordinary endoscopy(OR=0.270,95%CI:0.149-0.488,p<0.001;OR=0.528,95%CI:0.330-0.845,p=0.008;OR=0.536,95%CI:0.334-0.861,p=0.010).Patients with previous experience in painless endoscopy tended to choose painless endoscopy the next time,while patients with previous experience in ordinary endoscopy tended to choose ordinary endoscopy the next time(χ^(2)=140.97,p<0.001).From 2018 to 2021,the proportion of painless endoscopy has increased yearly(p<0.001).Most patients indicated that they would“regularly review gastroenteroscopy”(477/838,56.9%).Conclusions With Suichang County of Zhejiang Province as the representative,the demand for painless endoscopy for people's gastrointestinal cancer detection in southeast China has been increasing yearly.The development of endoscopy centers in county-level hospitals can basically meet the demand growth.Meanwhile,advanced concepts such as comfortable medical care and regular follow-up are gradually popularized at the grassroots level in southeast China.
