Clinical Study Of Different Doses Of Afentanil Combined With Propofol In Painless Colonoscopy Of Elderly Patients

Objective To observe the effect of different analgesic doses of Afentanil combined with propofol in painless colonoscopy of elderly patients,and to explore the better anesthesia medication scheme for painless colonoscopy.Methods A total of 126 elderly patients,aged 65-80 years old,regardless of gender,Body mass index（BMI）18-28 kg/m²,rated by the American Society of Anesthesiologists（ASA）Grade Ⅰ-Ⅱ.The aged patients were divided into three groups by random number table method:afentanil Sμg/kg group（N₁ group）,afentanil 7.5μg/kg group（N2 group）,and afentanil 10μg/kg group（N₃ group）,with 42 cases in each group.modified observer’s assessment of alertness/sedation（MOAA/S）≤2 was classified as the admission standard.heart rate（HR）、pulse oxygen saturation（SpO₂）and mean arterial pressure（MAP）were recorded Imin before anesthesia induction（T₁）,after anesthesia induction（T₂）,immediately after endoscopic operation（T₃）,colonoscopy to ileocecal part（T₄）,and after surgery（T₅）.The success rate of anesthesia and sedation,dosage of propofol,sedation induction time,colonoscopy time,sedation and recovery time,use of vasoactive drugs and physician satisfaction were recorded.Postoperative kinesthetic reactions,hypoxemia,sinus bradycardia,hypotension,postoperative dizziness,postoperative nausea and vomiting,and postoperative Fatigue Syndrome（POFS）were recorded.Results Finally,40 patients in each of the three groups completed the study.（1）In terms of safety,compared with T₁,MAP in T_2-5 groups was significantly decreased（P<0.05）,and HR in N₁ group was significantly increased at T3（P<0.05）;Compared with N₃ group,the incidence of intraoperative hypoxemia in N₁ and N₂ groups was lower（P<0.05）.Compared with Ni group,the incidence of intraoperative hypotension and postoperative POFS in N₂ and N₃ groups were lower（P<0.05）.（2）In terms of effectiveness,compared with Ni group,the total dosage of propofol,supplementary times,anesthetic induction time,recovery time and use of vasoactive drugs in N₂ and N₃ groups were decreased,and the success rate of anesthetic sedation was significantly increased（P<0.05）.Compared with the N₂ groups the satisfaction of physicians in N₁ and N₃ groups was lower（P<0.05）.Conclusion Afentanil 7.5μg/kg combined with propofol in elderly patients with painless colonoscopy has a higher first sedation success rate,stable hemodynamic effects,lower incidence of total adverse reactions,less total amount of propofol and shorter recovery time,which can provide a certain reference for clinical application.