Application of small dose of ketamine combined with dexmedetomidine during painless colonoscopy in elderly patients

Lu Yunhong; Chen Huiyu; Cao Xiaofei

doi:10.3760/cma.j.issn.1673-4777.2015.12.018

Abstract：Objective To explore the application of small dose of ketamine combined with dexmedetomidine during painless colonoscopy in elderly patients.Methods One hundred elderly patients undergoing painless colonoscopy were randomly divided into observation group (50 cases) anaesthetized with ketamine combined with dexmedetomidine and the control group (50 cases) anaesthetized with propofol.The heart rate (HR), mean arterial pressure (MAP) and respiratory rate (RR) were monitored and recorded before anesthesia(To) , when operation started (T1), when colonoscopy reached to ileocecal valves (T2), when operation ended (T3) and when anaesthesia recovered (T4);the operation duration, time of anaesthesia recovery, use of atropine and ephedrine,incidences of intraoperative and postoperative adverse reactions were recorded.Results The operation duration and time of anaesthesia recovery had no significantly differences between groups (P ＞ 0.05).The MAP, HR and RR in observation group were significantly higher/faster than those in control group at T1 [(78 ± 11) mmHg vs (66 ± 11) mmHg , (84 ± 10) times/min vs (64 ± 8) times/min, (17.8 ± 3.7) times/min vs (9.6 ± 4.4) times/min];the HR in observation group was significantly slower than that in control group at T2 [(76 ± 10) times/min vs (88 ± 9) times/min] (P ＜ 0.05).During operation, the incidences of hypotension, bradycardia, hyoxemia,body movement response, injection pain in control group were significantly higher than those in control group [58.0％ (29/50) vs 6.0％ (3/50), 38.0％ (19/50) vs 12.0％ (6/50), 20.0％ (10/50) vs 4.0％ (2/50),10.0％ (5/50)vs 8.0％ (4/50), 84.0％ (42/50)vs 0.0％ (0/50)] (P＜0.05).The uses of atropine and ephedrine had no significant differences between the two groups (P ＞ 0.05).Conclusion Small dose of ketamine combined with dexmedetomidine has good sedation and analgesia effects on painless colonoscopy in elderly patients.