Oxycodone Hydrochloride And Fentanyl On Elderly Patients During Endoscopic Retrograde Cholangio-Pancreatography Comparison Of The Effects

Objective:To investigate the effectiveness,safety and comfort of propofol combined with Oxycodone hydrochloride injection or fentanyl citrate injection on elderly patients during ERCP.Methods:Eighty cases of elderly patients undergoing ERCP that selected in First Clinical Hospital of Jilin University during November 2014-April2015.ASA II or III level including 43 males and 37 females;age(70 to 85)years; weight(40 to 78) kg. were randomly divided into oxycodone combined with propofol group(group O) and fentanyl combined with propofol group(group F), 40 cases in each group. The patients that operation time was less than 5 min or longer than 60 min, with severe cardiopulmonary systemic disease and a history of food and drug allergy were excluded. The patients were induced with oxycodone 0.1mg/kg in group O, fentanyl 1μg/kg in group F, and propofol 2mg/kg inboth groups.Then maintained with propofol 3 to 5 mg/kg.(h). Thisresearch used Nacrotrend monitor depth of anesthesia monitoring BIS value to determine the depth of anesthesia during operation to ensure that the BIS value is about 55, and adjusted the dose of propofol by BIS value.Basic vital signs and BIS Value were recorded at following time points:entering the operating room(T0),after induction 5 min later(T1),entering the endoscope(T2),taking the stone(T3),exiting endoscope(T4),the patient awake(T5) and dose of propofol,duration of surgery, recovery time, 30 min postoperative pain score and adverse effect including glossoptosis, twisted body and respiratory depression were observed and recorded.Results:There was no significant difference in general condition such as weight,age,duration of anesthesia,surgery time,even MAP,HR,RR,et al(P >0.05),There was no significant difference in operation time and recovery time between the two groups. But compared with fentanyl,the maintain dosage of propofol,the incidence of adverse reactions such as cough, body movement, respiratory depression, and 30 min postoperative pain score were decreased in group oxycodone.Conclusion:Both anesthetic methods can meet the requirements for elderly patients anesthesia during ERCP to ensure hemodynamic stable.While compared with fentanyl,Oxycodone can reduce the dosage of propofol,the incidence of respiratory depression and other adverse effects.Oxycodone could also have some advantages over fentanyl in visceral pain. So oxycodone combined with propofol on elderly patients undergoing therapeutic ERCP is a better choice.