Ji Liu, Ming Sun, Weiwu Fang, Changqing Zhong, Xuewu Xu, Yan Lv, Lin Zhao, Qiang Li, Ying Zhang, Ming Zou, Yong Wang, Xiaochen Wang
{"title":"依托咪酯联合舒芬太尼、芬太尼或地佐辛对无痛胃镜患者意识指数和不良反应的影响:一项随机对照单盲试点研究","authors":"Ji Liu, Ming Sun, Weiwu Fang, Changqing Zhong, Xuewu Xu, Yan Lv, Lin Zhao, Qiang Li, Ying Zhang, Ming Zou, Yong Wang, Xiaochen Wang","doi":"10.1016/j.gande.2022.11.007","DOIUrl":null,"url":null,"abstract":"<div><h3>Objective</h3><p>To use etomidate in combination with different opioids (sufentanil, fentanyl, and dezocine) to compare several anesthesia options from the aspects of the patient's index of consciousness (IoC).</p></div><div><h3>Methods</h3><p>This was a prospective pilot study of consecutive patients who were scheduled for elective painless gastroscopy at PLA Strategic Force Characteristic Medical Center, Beijing, China, between December 2020 and May 2022. The patients were randomized to control (etomidate), S (sufentanil + etomidate), F (fentanyl + etomidate), and D (dezocine + etimidate). IoC was measured before anesthesia (T1), opioids (T2), etomidate (T3), the start of endoscopy (T4), drug withdrawal (T5), OAA/S > 2 (T6), and OAA/S > 4) (T7). The primary outcome was the observation of IoC at T6 and T7. The adverse reaction and recovery time were secondary outcomes.</p></div><div><h3>Results</h3><p>With 20 patients in each group, there were no differences in the operation and awakening times among the four groups (P > 0.05). Compared with group C, the IoC values of groups S and F at T5, T6, and T7 were increased after drug administration (P < 0.05), with intragroup differences (P < 0.001). Compared with group C, the IoC values of groups S, F, and D were higher at T6 and T7 (P<sub>S-T6</sub> = 0.003, P<sub>F-T6</sub> = 0.013, P<sub>D-T6</sub> = 0.015; P<sub>S-T7</sub> = 0.015, P<sub>F-T7</sub> = 0.040, P<sub>D-T7</sub> = 0.028). There were differences in nausea and vomiting between groups D and C (P<sub>D-C</sub> = 0.044) and myoclonus (P<sub>S</sub>–<sub>C</sub><img>P<sub>F-C</sub><0.001, and P<sub>D-C</sub><0.001). SpO2 <90% (two cases in group S and one in group F) were observed.</p></div><div><h3>Conclusion</h3><p>IoC value has a good correlation with OAA/S score, which can accurately monitor the effect of etomidate combined with opioids on the depth of anesthesia of patients undergoing painless gastroscopic anesthesia.</p></div><div><h3>Trial registration</h3><p>ChiCTR, ChiCTR2000040927. Registered December 16, 2020 –Prospective registration, <span>http://www.chictr.org.cn/</span><svg><path></path></svg>ChiCTR2000040927.</p></div>","PeriodicalId":100571,"journal":{"name":"Gastroenterology & Endoscopy","volume":"1 1","pages":"Pages 18-23"},"PeriodicalIF":0.0000,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Comparison of the effects of etomidate combined with sufentanil, fentanyl, or dezocine on the consciousness index and adverse reactions for painless gastroscopy: A randomized controlled single-blinded pilot study\",\"authors\":\"Ji Liu, Ming Sun, Weiwu Fang, Changqing Zhong, Xuewu Xu, Yan Lv, Lin Zhao, Qiang Li, Ying Zhang, Ming Zou, Yong Wang, Xiaochen Wang\",\"doi\":\"10.1016/j.gande.2022.11.007\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Objective</h3><p>To use etomidate in combination with different opioids (sufentanil, fentanyl, and dezocine) to compare several anesthesia options from the aspects of the patient's index of consciousness (IoC).</p></div><div><h3>Methods</h3><p>This was a prospective pilot study of consecutive patients who were scheduled for elective painless gastroscopy at PLA Strategic Force Characteristic Medical Center, Beijing, China, between December 2020 and May 2022. The patients were randomized to control (etomidate), S (sufentanil + etomidate), F (fentanyl + etomidate), and D (dezocine + etimidate). IoC was measured before anesthesia (T1), opioids (T2), etomidate (T3), the start of endoscopy (T4), drug withdrawal (T5), OAA/S > 2 (T6), and OAA/S > 4) (T7). The primary outcome was the observation of IoC at T6 and T7. The adverse reaction and recovery time were secondary outcomes.</p></div><div><h3>Results</h3><p>With 20 patients in each group, there were no differences in the operation and awakening times among the four groups (P > 0.05). Compared with group C, the IoC values of groups S and F at T5, T6, and T7 were increased after drug administration (P < 0.05), with intragroup differences (P < 0.001). Compared with group C, the IoC values of groups S, F, and D were higher at T6 and T7 (P<sub>S-T6</sub> = 0.003, P<sub>F-T6</sub> = 0.013, P<sub>D-T6</sub> = 0.015; P<sub>S-T7</sub> = 0.015, P<sub>F-T7</sub> = 0.040, P<sub>D-T7</sub> = 0.028). There were differences in nausea and vomiting between groups D and C (P<sub>D-C</sub> = 0.044) and myoclonus (P<sub>S</sub>–<sub>C</sub><img>P<sub>F-C</sub><0.001, and P<sub>D-C</sub><0.001). SpO2 <90% (two cases in group S and one in group F) were observed.</p></div><div><h3>Conclusion</h3><p>IoC value has a good correlation with OAA/S score, which can accurately monitor the effect of etomidate combined with opioids on the depth of anesthesia of patients undergoing painless gastroscopic anesthesia.</p></div><div><h3>Trial registration</h3><p>ChiCTR, ChiCTR2000040927. Registered December 16, 2020 –Prospective registration, <span>http://www.chictr.org.cn/</span><svg><path></path></svg>ChiCTR2000040927.</p></div>\",\"PeriodicalId\":100571,\"journal\":{\"name\":\"Gastroenterology & Endoscopy\",\"volume\":\"1 1\",\"pages\":\"Pages 18-23\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2023-01-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Gastroenterology & Endoscopy\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S2949752322000085\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Gastroenterology & Endoscopy","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2949752322000085","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
Comparison of the effects of etomidate combined with sufentanil, fentanyl, or dezocine on the consciousness index and adverse reactions for painless gastroscopy: A randomized controlled single-blinded pilot study
Objective
To use etomidate in combination with different opioids (sufentanil, fentanyl, and dezocine) to compare several anesthesia options from the aspects of the patient's index of consciousness (IoC).
Methods
This was a prospective pilot study of consecutive patients who were scheduled for elective painless gastroscopy at PLA Strategic Force Characteristic Medical Center, Beijing, China, between December 2020 and May 2022. The patients were randomized to control (etomidate), S (sufentanil + etomidate), F (fentanyl + etomidate), and D (dezocine + etimidate). IoC was measured before anesthesia (T1), opioids (T2), etomidate (T3), the start of endoscopy (T4), drug withdrawal (T5), OAA/S > 2 (T6), and OAA/S > 4) (T7). The primary outcome was the observation of IoC at T6 and T7. The adverse reaction and recovery time were secondary outcomes.
Results
With 20 patients in each group, there were no differences in the operation and awakening times among the four groups (P > 0.05). Compared with group C, the IoC values of groups S and F at T5, T6, and T7 were increased after drug administration (P < 0.05), with intragroup differences (P < 0.001). Compared with group C, the IoC values of groups S, F, and D were higher at T6 and T7 (PS-T6 = 0.003, PF-T6 = 0.013, PD-T6 = 0.015; PS-T7 = 0.015, PF-T7 = 0.040, PD-T7 = 0.028). There were differences in nausea and vomiting between groups D and C (PD-C = 0.044) and myoclonus (PS–CPF-C<0.001, and PD-C<0.001). SpO2 <90% (two cases in group S and one in group F) were observed.
Conclusion
IoC value has a good correlation with OAA/S score, which can accurately monitor the effect of etomidate combined with opioids on the depth of anesthesia of patients undergoing painless gastroscopic anesthesia.
Trial registration
ChiCTR, ChiCTR2000040927. Registered December 16, 2020 –Prospective registration, http://www.chictr.org.cn/ChiCTR2000040927.
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