Application of Propofol Combined with Dexmedetomidine or Midazolam in Painless Gastrointestinal Endoscopy in the Elderly

Yuan YANG; Li-jia PENG; Lan-qing PU; Jun-jie LI; Jian-lin SHAO; Xin YANG

doi:10.12259/j.issn.2095-610X.S20210221

Volume 42 Issue 2

Mar. 2021

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Yuan YANG, Li-jia PENG, Lan-qing PU, Jun-jie LI, Jian-lin SHAO, Xin YANG. Application of Propofol Combined with Dexmedetomidine or Midazolam in Painless Gastrointestinal Endoscopy in the Elderly[J]. Journal of Kunming Medical University, 2021, 42(2): 43-48. doi: 10.12259/j.issn.2095-610X.S20210221

Citation:

Yuan YANG, Li-jia PENG, Lan-qing PU, Jun-jie LI, Jian-lin SHAO, Xin YANG. Application of Propofol Combined with Dexmedetomidine or Midazolam in Painless Gastrointestinal Endoscopy in the Elderly[J]. Journal of Kunming Medical University, 2021, 42(2): 43-48. doi: 10.12259/j.issn.2095-610X.S20210221

Citation:

Yuan YANG, Li-jia PENG, Lan-qing PU, Jun-jie LI, Jian-lin SHAO, Xin YANG. Application of Propofol Combined with Dexmedetomidine or Midazolam in Painless Gastrointestinal Endoscopy in the Elderly[J]. Journal of Kunming Medical University, 2021, 42(2): 43-48. doi: 10.12259/j.issn.2095-610X.S20210221

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Application of Propofol Combined with Dexmedetomidine or Midazolam in Painless Gastrointestinal Endoscopy in the Elderly

doi: 10.12259/j.issn.2095-610X.S20210221

1.
Dept. of Anesthesiology，The First Affiliated Hospital of Kunming Medical University，Kunming Yunnan 650032
2.
Graduate School of Kunming Medical University，Yunnan Kunming 650500，China

Received Date: 2020-12-04
Publish Date: 2021-03-05

Abstract

Abstract

Objective To investigate the impact of propofol combined with Dexmedetomidine （Dex） or midazolam on the clinical effect, postoperative cognitive function and adverse reactions in elderly's painless gastrointestinal endoscopy. Methods Three hundreds and forty elderly patients who underwent joint painless gastroscopy from September 2018 to April 2019 were selected. Two hundreds and fifty patients were randomly divided into five groups （n = 50）, Dex group （D1, D2, D3 group） was given intravenous injection of dexmedetomidine 0.25 μg / kg, 0.5 μg / kg, 0.75 μg / kg respectively （within 15 minutes）. In the midazolam group （group M）, 0.03 mg / kg was injected intravenously 15 minutes before surgery. The control group （group C） was given an equivalent volume of 0.9% sodium chloride solution. The rest of the anesthesia protocol is same. We recorded vital signs and adverse reactions during the operation and got the best Dex dose. The rest 90 patients were randomly divided into 3 groups （n = 30）, Dex group （D group）, midazolam group （M2）, and control group （C2）. Montreal Cognitive Assessment Scale （MOCA） was used to evaluate cognitive function at preoperative （T0）, and 5min （T1）, 30min （T2）, 1h （T3）, 2 h （T4）, 6 h （T5） after awakening. Results Group C had the largest amount of propofol （P < 0.05）. The recovery time of D3 and M groups was longer than that of D1, D2 and C （P < 0.05）. The incidence of respiratory depression was the highest in group C, followed by group M （P < 0.05）. The incidence of bradycardia in group D3 was the highest, followed by group D2 （P < 0.05）; group C had the most body movements, and group D3 had the least （P < 0.05）; the incidence of Postoperative cognitive dysfunction （POCD） in group M2 was higher than that in group D （P < 0.05）. Conclusion Propofol combined with 0.5 ug/kg dexmedetomidine can reduce the occurrence of adverse reactions and early POCD in elderly's painless gastrointestinal endoscopy.
- Gastroscopy,
- Elderly,
- Dexmedetomidine,
- Propofol,
- Anesthesia under surveillance,
- Cognitive dysfunction

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References

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