Effect Of Target-controlled Infusion Of Propofol Combined With Dexmedetomidine On Indolent Enteroscope For Obese Patients

Objective To evaluate the effect and safety with target-controlled infusion of propofol combined with Dexmedetomidine on indolent enteroscope for obese patients.Then find the better method which is suitable for obese patients.Methods Ninety patients with ASA Physical statusⅠ~Ⅱ, aged 30~50 years,BMI: 28~32 kg/m2, scheduled for sedation were randomly allocated into propofol group or dexmedetomidine combined with propofol group with 45 case each. The obesity patients in each group were randomly assigned into three subgroups(n=15 each), group P1-3 receieving TCI of propol with the target blood-site concentration set at 2, 3 and 4μg/ml respectively. Groups DP1-3 receieved intravenous infusion of dexmedetomidine 0.3μg/kg within 10 mins and TCI of propofol with the target blood-site concentration set at 2, 3 and 4 μg/ml respectively 15 min after the infusion of dexmedetomidine. BIS、MAP、HR、RR and SPO2 were monitored at the follow time before anesthesia(T0), 5 min before injection propofol(T1), no consciousness after inject propofol(T2), 1min after enteroscopy operation(T3), 5min after enteroscopy operation(T4), finished enteroscopy(T5) and awaked(T6). The movement, bradycardia, hypotension, respiratory inhibition, nausea, regurgitation, bucking, intraoperative awareness and analepsia quality, departure scores were also recorded.Results Compared with group P1, group DP1 is more stable, with better depth of sedation, more stable hemodynamics., good quality of the waking up as well as the departure score, without additional propofol, respiratory inhibition, movement(P < 0.05). Compared with DP2 and DP3 group, group DP1, the smallest amount of propofol, behaving more stable hemodynamic, no respiratory depression, high awakening quality, high departure scores(P < 0.05). Simple use of propofol group(P1-3) appear bucking, and use Dex groups(DP1-3) were not appear bucking(P < 0.05), the difference had statistical significance). Each group has no reflux adverse reactions such as aspiration, nausea, vomiting, intraoperative awareness.Conclusion Maintain a certain depth of anesthesia in the premise, Dex(loading dose of 0.3 μg / kg) composite TCI propofol(target plasma concentration of 2μg / ml), for obese patients undergoing enteroscopy is satisfactory and safety.