Comparison Of The Anesthetic Effect Between Midazolam And Propofol In Endoscopic Retrograde Cholangiopancreatography

Objectives:The efficacy and safety of midazolam and propofol in endoscopic retrograde cholangiopancreatography?ERCP?were compared under the combined use of oxycodone.Methods:Sixty ASA?American Society of Anesthesiologists?II or III patients undergoing Endoscopic retrograde cholangiopancreatography?ERCP?were randomly allocated to one of two groups.Group P?n=30?received propofol target-controlled infusion?TCI,target site concentration 3?g/ml at induction,reduced to 2-3?g/ml during general anaesthesia maintenance and titrated to a BIS?bispectral index?of 40-60?and0.1mg/kg oxycodone for anesthesia.Group M?n=30?received 0.1mg/kg midazolam and 0.1mg/kg oxycodone for anesthesia induction and 0.05-0.1mg/kg·h midazolam for anaesthesia maintenance and titrated to a BIS of 40-60.The injection rate of midazolam is 1mg/min.Patients in both groups were not included in the study if they coughed or moved their bodies during the operation.After the surgery,all the patients in Group M received 0.3-0.5mg flumazenil to get rapid awakening,patients in Group P were stopped from propofol infusion.BIS after anesthesia,intraoperative and postoperative complications,including hypoxia,bradycardia,hypotension,nausea and vomiting,and patients'satisfaction score were recorded.HR,MAP,SPO₂ and BIS at the time of arrival of the operating room?T₀?,3 min after induction?T₁?,endoscope through the throat?T₂?,endoscope through the duodenal papilla?T₃?,during the process of operation?the mean value of any 3 times during the operation??T₄?and the time when patients regained consciousness?T₅?were recorded.Results:In total,60 patients were enrolled in this prospective study and were randomized to Group P?n=30?and Group M?n=30?.The number of patients with adverse reactions during the operation in Group P and Group M were 10?33.33%?and 1?3.33%?,respectively?P=0.003?.Patient satisfaction score in Group P and Group M were 8.23±0.94 and 9.03±0.81,respectively?P=0.001?.And there were no difference between the two groups at T₀.HR was significantly higher in Group M than in Group P at T₂,T₃ and T₄.MAP was significantly higher in Group M than in Group P at T₁,T₂and T₃.SpO₂ was significantly higher in Group M than in Group P at T₄.Conclusions:Midazolam and oxycodone anesthesia for ERCP is safe and may reduce the incidence rate of respiratory inhibition,decrease of heart rate and blood pressure.Patients are more satisfied with the use of midazolam than propofol.It's suitable for clinical promotion.