Application And Dosage Of Propofol During Induction Of Anesthesia For Colonoscopy In Patients With Different Body Mass Index

Objective Observe the safety of propofol in overweight and obese patients during the induction of colonoscope anesthesia,and explore the correlation between total weight,ideal body weight,lean body weight and propofol induction dose.Methods Ninety six patients were selected for painless colonoscopy from March 2019 to June 2019 at the Affiliated Hospital of yanbian University,aged 18～72 years,with a body mass of 45～100 kg,and ASA grade Ⅰ or Ⅱ.According to BMI,the patients were divided into three groups:Group A(normal weight group)and 42 patients(BMI 18.5～23.9kg/m2).Group B(superreorganization)consisted of 33 patients with BMI24.0～27.9 kg/m2.Group C(obesity group)had 21 people with BMI≥28.0 kg/m2.All patients were connected to an ecg monitor after entering the room to monitor blood pressure,heart rate,electrocardiogram and oxygen saturation.All patients were given 50 g of fentanyl prior to examination.After 30s,propofol injection(3s/mL)was injected slowly and evenly with the gradual effect of fentanyl,and the patient was observed for muscle relaxation,vague consciousness,eyelid closure,and light untimely breathing to confirm the reflection of eyelashes.Propofol injection was stopped when the eyelash reflection disappeared,the dose of propofol was recorded,and the endoscopic examination began immediately.When entering the examination room,at the beginning of the examination,3min after the examination,and 6min after the examination were set as T0,T1,T2 and T3,respectively.The mean arterial pressure,heart rate and blood oxygen saturation at each time point were recorded.Observe and record the complications and adverse reactions during and after the examination.Result 1.Propofol induced dose:the total dose of propofol induced in groups B and C was greater than that in group A,the difference was statistically significant(P<0.05);the total induced dose of propofol per kilogram of group B and C was less than that in group A,The difference was statistically significant(P<0.05);the induction dose of propofol per kilogram of ideal body weight in groups B and C was greater than that in group A,and the difference was statistically significant(P<0.05);There was no statistically significant difference in dose(P>0.05).2 Hemodynamics:There is no statistically significant difference in the average arterial pressure change in each time period of the three groups of patients(P>0.05);there is no statistically significant difference in the change of heart rate in each time period of the three groups of patients(P>0.05);Among the patients in group C,the change of blood oxygen saturation in group C during ΔT1 and ΔT2 was greater than that in group A,the difference was statistically significant(P<0.05).3.Complications:The three groups of patients had no statistically significant difference in anesthesia complications such as respiratory depression,decreased heart rate,and decreased blood pressure(P>0.05).4.Number of propofol additions:There was no statistically significant difference in the number of propofol additions among the three groups(P>0.05).Conclusion 1.In this experiment,the induced dose of propofol per kg of lean body mass did not change with the increase of BMI,indicating that overweight and obese patients can be given normal weight patients with LBW as a body weight scale to give propofol,which has certain clinical significance.2.Propofol has fewer adverse reactions and complications during colonoscopy anesthesia induction,and can be safely used for anesthesia induction in overweight and obese patients.