丙泊酚与瑞芬太尼镇静用于择期胃镜检查：一项随机对照试验。
完整摘要 · 中文译文
目的：丙泊酚和瑞芬太尼广泛用于择期胃镜检查的镇静。本随机对照试验旨在比较两者的安全性特征、患者报告的恢复质量及内镜医师满意度。 方法：本单中心随机对照试验纳入88例接受择期胃镜检查的成人患者（美国麻醉医师学会分级I-III级），按1:1随机分配至丙泊酚组（P组，n=44）或瑞芬太尼组（R组，n=44）。采用脑电双频指数（目标60-80）和Ramsay镇静评分（目标2-3）标准化镇静深度。主要结局为术后30 min的恢复质量-15评分；次要结局包括并发症发生率、苏醒时间和内镜医师满意度。 结果：恢复质量-15评分相当（中位数140 vs. 140；中位数差异0，95%CI -1.0至1.0；p=0.95）。P组总并发症发生率为0%，R组为61.4%（p<0.001），包括心动过缓（27.3%）、术后恶心呕吐（20.5%）和血氧饱和度下降（13.6%）。R组苏醒时间更短（3 vs. 60 s；p<0.001）。P组内镜医师满意度显著更高（优秀评分90.9 vs. 56.8%；p=0.003）。 结论：尽管患者报告的恢复质量相当，丙泊酚与围手术期不良事件显著更少（0 vs. 61.4%）及内镜医师满意度更高相关，支持其在常规择期胃镜检查镇静中优先使用。 临床试验注册号：ClinicalTrials.gov，NCT07336628。注册日期2026年1月2日。
完整摘要 · 英文原文
OBJECTIVE: Propofol and remifentanil are widely used for elective gastroscopy sedation. The aim of this randomized controlled trial was to compare their safety profiles, patient-reported recovery quality, and endoscopist satisfaction. METHODS: This single-center randomized controlled trial enrolled 88 adults (American Society of Anesthesiologists I-III) undergoing elective gastroscopy, allocated 1:1 to propofol (Group P, n=44) or remifentanil (Group R, n=44). Sedation depth was standardized using the Bispectral Index (target 60-80) and Ramsay Sedation Scale (target 2-3). The primary outcome was the Quality of Recovery-15 score at 30 min post-procedure; secondary outcomes included complication incidence, awakening time, and endoscopist satisfaction. RESULTS: Quality of Recovery-15 scores were comparable (median 140 vs. 140; median difference 0, 95%CI -1.0 to 1.0; p=0.95). Total complication incidence was 0% in Group P versus 61.4% in Group R (p<0.001), comprising bradycardia (27.3%), postoperative nausea and vomiting (20.5%), and desaturation (13.6%). Awakening time was shorter in Group R (3 vs. 60 s; p<0.001). Endoscopist satisfaction was significantly higher in Group P (90.9 vs. 56.8% excellent scores; p=0.003). CONCLUSION: Despite comparable patient-reported recovery quality, propofol was associated with substantially fewer perioperative adverse events (0 vs. 61.4%) and higher endoscopist satisfaction, supporting its preferential use in routine elective gastroscopy sedation. CLINICAL TRIAL REGISTRATION NUMBER: ClinicalTrials.gov, NCT07336628. Registered January 2, 2026.