Influences of low-dose midazolam combined with propofol on anesthesia effect and recovery quality in elderly patients undergoing painless gastroscopy

Zhao Yan-yan; Gao Yu-heng; Cao Shi-ming

doi:10.3969/j.issn.1672-8157.2025.01.025

Abstract：Objective To explore the influences of low-dose midazolam combined with propofol on anesthesia effect and recovery quality in elderly patients undergoing painless gastroscopy.Methods A total of 120 elderly patients undergoing pain-less gastroscopy in Lianshi People's Hospital from June 2022 to August 2023 were retrospectively selected as the research objects.According to the anesthesia method,they were divided into the combined group(n=60,midazolam combined with propofol)and propofol group(n=60).The patients in the propofol group were given propofol while those in the combined were given low-dose midazolam in combination with propofol for anesthesia.The anesthesia effect(dosage of propofol,awaking time,recovery time of orientation),hemodynamics(heart rate(HR),mean arterial pressure(MAP))before anesthesia(T0),at 5 min after anesthesia(T1)and after awakening(T2),recovery quality(40-item quality of recovery score(QOR-40))at T0 and 1 h after after surgery(T3),cognitive function(mini-mental state examination(MMSE))at T0,T3,2 h after after surgery(T4),3 h after after surgery(T5),cerebral ischemia(cerebral blood volume(CBV),cerebral blood flow(CBF),mean transit time(MTT),time to peak(TTP))at T0 and T3 and adverse reactions were compared between the two groups.Results The dosage of propofol in the combined group was(93.70±20.42)mg,lower than that of(128.36±31.98)mg in the propofol group,and the difference was statistically significant(t=7.076,P<0.05).The awaking time and recovery time of orientation in the combined group((9.12±1.68)min and(15.65±3.16)min,respectively)were shorter than those in the propofol group((11.03±2.09)min and(18.33±3.37)min,respectively),and the difference was statistical-ly significant(t=5.517,4.494,both P<0.05).The HR and MAP at T1 and T2 in the the combined group((76.53±4.26)times·min-1,(80.07±4.90)times·min-1 and(72.78±4.25)mm Hg(1 mm Hg≈0.133 kPa),(78.95±5.13)mm Hg)were lower than those in the propo-fol group((78.81±3.72)times·min-1,(82.44±4.88)times·min-1 and(76.67±4.56)mm Hg,(82.02±5.77)mm Hg),the differences were statistically significant(t=3.123,2.665,4.834,3.080,all P<0.05).At T2,the scores of physical comfort,pain and emotional state,and total score in the combined group((50.78±3.56)points,(28.87±3.06)points,(37.82±3.69)points,(167.59±13.65)points)were higher than those in the propofol group((48.32±3.80)points,(26.76±3.13)points,(36.17±3.33)points,(160.53±15.28)points),and the difference was statistically significant(t=3.659,3.734,2.571,2.669,all P<0.05).The MMSE scores at T3,T4 and T5 in the com-bined group((23.25±1.89)points,(24.71±1.77)points,(25.27±1.36)points)were higher than those in the propofol group((21.79±1.76)points,(23.63±1.65)points,(24.52±1.29)points),and the difference was statistically significant(t=4.379,3.457,3.099,all P<0.05).At T3,the levels of CBF and CBV in the combined group((47.63±7.61)mL·(100 g·min)-1 and(39.05±5.12)mL·100 g-1)were higher than those in the propofol group((44.19±7.08)mL·(100 g·min)-1 and(36.37±4.86)mL·100 g-1),and the levels of TTP and MTT in the combined group((110.43±19.22)s,(114.96±11.56)s)were lower than those in the propofol group((118.7±20.86)s,(122.32±13.28)s),and the difference was statistically significant(t=2.564,2.941,2.258,3.238,all P<0.05).There was no significant difference in adverse reactions between the combined group(10.00%,6/60)and the propofol group(6.67%,4/60)(χ2=0.436,P>0.05).Conclusion Low-dose midazolam combined with propofol can effectively improve anesthesia effect and recovery quality in elderly patients undergoing painless gastroscopy since it has has fewer effects on hemodynamics and cognitive function,and is of high safety.