The Effects Of Different Doses Of Dexmedetomidine Compounded Propofol On Endoscopic Retrograde Cholangiopancreatography On The Senile People

Objective:To evaluate the effects of different doses of dexmedetomidinecompounded propofol on Endoscopic Retrograde Cholangio pancreato-graphy on the senile people.Methods:100patients,ASA Ⅱ or Ⅲ, aged65～85years old are scheduled forERCP. Then they were devided into4groups randomly:group C(normalsaline，NS)；group Dl(dexmedetomidine injected by0.3μg·kg-1·h-1)；group D2(dexmedetomidine injected by0.5μg·kg-1·h-1);groupD3(dexmedetomidine injected by0.7μg·kg-1·h-1).The patients of D1、D2and D3were given dexmedetomidine1.0μg·kg-1over10minutesintravenously as a loading dose and then followed by an infusion of0.3μg·kg-1·h-1、0.5μg·kg-1·h-1or、0.7μg·kg-1·h-1until the end ofsurgery;and the patients in group C were given saline10ml in the sametime.Anesthesia was maintained with propofol3～4mg/kgintravenously.Observe and record the SBP、DBP、HR、SPO2of eachpatient at following time points:the right time after the patient in theOR(T0),before the intubation(T1),after disappearance of eyelashreflex(T2) and the right time after the duodenum mirror into theesophagus (T3).Record cortisol concentration at T0,T3,and10min afteroperation.Record the total doses of propfol,operation time,recoverytime,body twisting and respiratory depression. The additional rate propfol and vasoactive agent during operation and side effects after opretion werefollowed up. Then take a Steward score of each patient at10min after theoperation.Results:Compared with group C, SBP and HR decreased significantly atT1、T3in group D1、D2and D3（P<0.05）.Compared with T2,SBP、DBP and HR of T3were significantly higher in group C and D1（P<0.05）;SBP、DBP and HR were decreased significantly at T3ingroup D3（P<0.05）; SBP、DBP and HR were stable at T3in groupD2(P>0.05).There was no significantly difference with the SpO2at T0、T1、T2、T3among4groups (P>0.05). Compared with group C,the totaldoses of propofol decreased significantly in group D1、D2and D3.Steward score decreased at T3in group D1、D2and D3(P<0.05).Theadditional rate propofol,usage rate of vasoactive agent and side effectsdecreased significantly,but atropine usage increased in group D1、D2andD3（P<0.05）.Compared with C group,cortisol decreased significantly ingroup D1、D2and D3（P<0.05）.Conclusions:Dex can be safe and effective for elderly patients with ERCPpropofol anesthesia. Dex injected by0.5μg·kg-1·h-1can reduce the dose ofpropofol. Dex does not affect the awakening time and help maintainelderly patients perioperative hemodynamics stability.