Application of Remifentanyl Combined with Low-dose Propofol for Conscious Sedation in Gastroscopy of Elderly Patients

WU Jian-xiong; LI Xu; XU Zhong-huang

doi:10.3969/j.issn.1002-3429.2018.07.009

Abstract：Objective To observe the efficacy and safety of remifentanil combined with low-dose propofol for conscious sedation in gastroscopy of elderly patients. Methods A total of 210 elderly patients with ASA stages Ⅰand Ⅱ who underwent gastroscopy from February 2016 to February 2017 were randomly assigned into observation group (n＝105) and control group (n＝105). In the control group, propofol was intravenously administered at 1 to 2 mg/kg ( longer than 60 s) . The patients fell asleep and the reflex of the eyelashes disappeared before the gastrosco-py began. In the observation group, the patients received intravenous remifentanil at 0. 5-1. 0 μg/kg combined with propofol at 0. 4-0. 6 mg/kg, while the patients remained awake. The gastroscopy was performed 30 seconds after in-jection. Intraoperative vital signs and postoperative complications as well as gastroscopy duration, awaking time, du-ration of recovery room stay were observed and documented. The satisfaction of the operator and the patient were fol-lowed up the day after gastroscopy. Results Vital signs in observation group was relatively stable, as compared with those in control group. The rate of apnea was significant higher, whereas incidence of SpO2decrease, hypotension, cough response, and body movement was significant lower in observation group compared with control grou p( P<0. 05 or P<0. 01) . There was no significant difference in duration of the procedure between the two groups ( P>0. 05), however, the awaking time, and duration of recovery room stay were shorter in observation group than in con-trol group, indicating significant differences (P<0. 01). Moreover, the rate of operator and patient satisfaction was higher in observation group than in control group ( P<0. 01) . Conclusion Remifentanil combined with low-dose propofol for conscious sedation has advantages of safety, good controllablity,stable circulation,rapid outpatient turn-over and simple operation in gastroscopy of elderly patients.