Efficacy Of Dexmedetomidine Combined With Propofol And Fentanyl In Patients Undergoing Endoscopic Retrograde Cholangiopancreatography

Objective:With the increasing complexity of endoscopic retrograde cholangiopancreatography（ERCP）,surgical stimulation has become stronger,so patients need deeper levels of sedation.This research aims at evaluating the safety and efficacy of dexmedetomidine（DEX）combined with propofol and fentanyl for anesthesia during ERCP.Methods:100 patients who underwent ERCP were allocated into two groups（Group PD and Group PF）,and they were all given 1μg·kg^-1 fentanyl and20 mg lidocaine at the beginning of sedation.In Group PD,every patient received DEX(0.5μg·kg^-1)and propofol(0.5 mg·kg^-1),and followed by a continuous infusion of DEX(0.5μg·kg^-1·h^-1)and propofol(2 mg·kg^-1·h^-1).In Group PF,every patient received propofol(1.5 mg·kg^-1),which was followed by a continuous infusion of 4 mg·kg^-1·h^-1.Hemodynamic and respiratory changes,sedation level（Narcotrend index[NI]and Ramsay Sedation Scale[RSS]）,as well as patient satisfaction and pain scores were assessed.What’s more,we also recorded discharge time,recovery time,and adverse events.Result:The respiratory rate（RR）and mean artery pressure（MAP）were maintained in Group PD,but decreased significantly in Group PF.The HR was lower in Group PD than that in Group PF.The episodes of Sp O₂<90%,coughing,breath holding and airway assistance were higher in Group PF than those in Group PD.RSS scores were higher and NI scores were lower in the Group PD than those in the Group PF,but the time of discharging from postanaesthesia care unit in Group PD was longer.And higher satisfaction scores and lower pain scores are observed in Group PD.Conclusion:DEX-propofol-fentanyl is superior to propofol-fentanyl for ERCP,because of more efficient respiratory and hemodynamic stability,higher RSS scores,higher satisfaction scores,and lower pain scores.