| Objective To study the safety and feasibility of propofol combined with sufentanil and remifentanil in Endoscopicretrograde Cholangio Pancreatography.Methods This study is aimed at 90 ERCP patients who require sedation and analgesia.They were randomly divided into three groups:a,b and c.Group A,as the control group,only received propofol infusion.Patients in groups B and C were given 0.05μg/kg sufentanil and 1.5μg/kg remifentanil respectively before Target-controlled infusion,TCI)propofol.TCI propofol effect chamber concentration starts anesthesia from 1.0μg/ml,and sedation level of patients is evaluated through a sedation scale RSS to adjust the concentration of propofol to gradually deepen anesthesia at a target concentration of 0.5μg/ml.When eyelash reflex of patients disappears and sedation state reaches 3-4,surgery starts.In case of body movement and cough,adjust the target concentration of propofol to deepen anesthesia by 0.3μg/ml each time,and withdraw the drug after surgery.Monitoring and recording indexes such as systolic blood pressure(SBP),diastolic blood pressure(DBP),heart rate(HR),blood oxygen saturation(SpO2),respiratory frequency(RR),end-expiratory carbon dioxide(PetCO2)and other indexes at various time points before anesthesia induction,after induction,after endoscope insertion,during biliary tract operation during operation,after withdrawal of endoscope after operation and during waking up,recording the incidence rate of adverse reactions,total dosage of propofol,sedation induction time and waking up recovery time,scoring patients’ sedation state and waking up state,and evaluating patients’ satisfaction.Results In the experiment,all three groups of patients can successfully complete ERCP related operations.1.SBP,DBP,RR and SpO2 in the three groups after anesthesia induction were significantly lower than those before anesthesia induction(P<0.05);PetCO2 was significantly higher than those before induction(P<0.05);HR in group C was significantly lower after induction than before induction,and the difference was statistically significant(P<0.05)..Inter-group comparison:SBP and DBP in group B and C were significantly lower than those in group A(P<0.05);RR in group B and C were significantly higher than those in group A(P<0.05);HR,SpO2 and PetC02 in group B and C were not significantly different at the time of T2,T3 and T4(P>0.05);2.There was no significant difference in adverse effects incidence among the three groups in terms of body activity,bradycardia,cough and vomiting(P>0.05);there were significant differences in respiratory depression,hypotension and the pain of propofol injection(P>0.05).3.There was no significant difference in RSS scores,satisfaction and recovery scores among the three groups(P<0.05).4.The total dosage of propofol in the three groups was significantly different(P<0.05).Among them,the total dose of propofol in group B and C was lower than that in group A.Moreover,the total dose used in group B was lower than that in group C.5.There were significant differences in induction time and recovery time between the three groups(P<0.05).Among them,the induction time and recovery time of group B and C were lower than those of group A.Moreover,group B was lower than group C.The above differences were statistically significant(P<0.05).Conclusion In this study,propofol combined with sufentanil has the best anesthesia effect,more stable hemodynamics,reduced the dosage of propofol during operation to the greatest extent,low incidence of adverse reactions,high satisfaction of patients who wake up quickly after operation,and good safety and feasibility. |
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