The Application of Tramadol Combined with Propofol in Painless Colonoscopy and Its Influence on Stress Response and Diaphragm Movement

LIN Zhiyuan; WENG Jiaquan; LIN Xin

doi:10.3639/j.issn.2095-3097.2024.05.026

Abstract：Objective To evaluate the application of tramadol combined with propofol in painless colonoscopy and its effects on stress response indicators and diaphragm movement. Methods A total of 120 patients receiving painless colonosco-py were randomly separated into group A and group B (60/group). Group A received fentanyl and propofol anesthesia,while group B received tramadol and propofol intravenous anesthesia. The stress indexes[cortisol (Cor),angiotensinⅡ(Ang-Ⅱ)],diaphragm movement indexes[diaphragm motion degree (DM),diaphragm thickening fraction (DTF)],anesthesia onset time,operation time,and narcotic drug use were compared between the two groups. The occurrence of adverse events during the examination was re-corded,and peri-examination sedation was assessed using the Richmond Agitation and Sedation Scale (RASS). Results There were no differences in RASS scores between group A and group B 10 and 20 minutes after anesthesia (P>0.05);RASS scores in group B were higher than those in group A 20 and 60 minutes after the operation (P<0.05). Serum Cor and Ang-Ⅱ in group B were lower than those in group A 5 minutes after anesthesia and 5 minutes after surgery (P<0.05).DM in group B was higher than that in group A 5 and 10 minutes after anesthesia (P<0.05);DTF in group B was higher than that in group A 5 and 10 minutes af-ter anesthesia and after surgery (P<0.05). The onset time of anesthesia in group A was shorter than that in group B (P<0.05),and there were no differences in colonoscopy operation time,total propofol usage,or the number of additional propofol doses between the two groups (P>0.05). The incidence of adverse events in group B was significantly lower than in group A (5.00％ vs 16.67％). Conclusion Fentanyl and tramadol combined with propofol can meet the intra-venous anesthesia requirements of painless colonoscopy.However,compared with fentanyl combined with propofol,the tramadol combined with propofol regimen can effectively reduce the stress response during surgery,minimize the impact on diaphragm movement,and reduce the risk of intraoperative adverse events,indicating tramadol combined with propofol may serve as a promising anesthetic regimen for painless colonoscopy.