Application Of Alfentanil Combined With Propofol In Painless Gastroscopy

Objective:To observe the effect of alfentanil combined with propofol at the equivalent analgesic dose of sufentanil in painless gastroscopy,and to explore a better anesthetic program for painless gastroscopy.Methods:After the review and approval of the hospital ethics committee,110patients who met the requirements and needed painless gastroscopy from January 2021to May 2021 were selected and randomly divided into 2 groups,55 patients in each group.The control group（Group S）was given 1-2 mg/kg propofol after 0.1μg/kg sufentanil,and the observation group（Group A）was given 1-2 mg/kg propofol after 4μg/kg alfentanil.All drugs should not be injected intravenously for less than 30 seconds.Modified observer’s assessment of alertness/sedation（MOAA/S）was performed immediately after the drug administration.Gastroscopy was inserted when MOAA/S≤2,and the MOAA/S≤3 during the operation.If the depth of sedation was insufficient,Propofol 3-5 m L was added.The success rate of first induction in both groups was the main observation index,and the secondary observation indexes included:mean arterial pressure（MAP）,heart rate（HR）and pulse oxygen saturation（Sp O₂）,end-tidal CO₂pressure（Pet CO₂）,respiratory rate（RR）of patients at 1min before induction（T₀）,immediately after endoscopy（T₁）,3min after operation（T₂）and immediately after awakening（T₃）,and induction onset time,awakening time,directional force recovery time,visual analogue scale（VAS）when awake,propofol dosage,satisfaction rate of patients,endoscopists and anesthesiologists,and occurrence of adverse reactions such as injection pain,respiratory depression,choking,body movement,nausea and vomiting,drowsiness,hypotension,bradycardia,blurred vision,etc.Results:Finally,50 patients in each group completed the experimental study.（1）There was no significant difference in the success rate of first induction,propofol consumption,VAS score when awake,HR,MAP,Pet CO₂at four time points,and satisfaction rate of patients,endoscopists and anesthesiologists between the two groups（P>0.05）;（2）In terms of respiratory rate,compared with group S,group A was significantly lower immediately after endoscopy（P<0.05）,and there was no significant difference between the two groups at other time（P>0.05）;（3）Compared with group S,group A had shorter onset time,awakening time and directional force recovery time,and lower incidence of total adverse reactions（P<0.05）.Conclusion:At the equivalent analgesic dose,analgesic gastroscopy using alfentanil combined with propofol anesthesia has the same high success rate of first induction as sufentanil,and compared with sufentanil,it has faster onset and recovery speed,shorter recovery time of orientation force,and lower incidence of total adverse reactions,which is more worthy of clinical application.