| Objective:The purpose of this experiment is to prove the safety and effectiveness of oxycodone in adult painless gastroenteroscopy,and to conduct the clinical study of the best dose of oxycodone for this diagnosis and treatment,so as to provide a reference scheme for clinical application.Methods:One hundred and twenty patients,aged from 20 to 65,who underwent painless gastroenteroscopy in the Central Hospital of China Japan Friendship Hospital of Jilin University from September to December,2021,were selected.Their height and mass index（BMI）（17.0 ～ 27.0）kg / m2 and American anesthesia classification（ASA）were grade I ～ II;They were randomly divided into four groups: S1,S2,S3 and D,with 30 cases in each group.Routine gastrointestinal preparation and fasting water.（1）Group S1: oxycodone 0.05mg/kg was slowly injected intravenously,and propofol 1.5～ 2mg/kg was injected intravenously after 5min;（2）S2 group: oxycodone 0.08mg/kg was slowly injected intravenously,propofol 1.5 ～ 2mg/kg was injected intravenously after 5min,（3）S3 group: oxycodone 0.11mg/kg was slowly injected intravenously,propofol 1.5 ～ 2mg/kg was injected intravenously after 5min;（4）Group D:intravenous injection of propofol 1.5 ～ 2mg/kg.When the patients in each group did not respond to the call of name and the eyelash reflex disappeared,gastroenteroscopy was performed.If the body movement is caused by examination stimulation,add propofol 0.5 ～ 1mg / kg as the examination progresses,and wait for 30 s until the patient can tolerate the examination.The changes of heart rate（HR）,mean arterial pressure（map）and Sp O2 were observed and recorded when patients entered the room（T0）,1 min after induction（T1）,gastroscope（T2）,enteroscope through splenic curve（T3）and enteroscope through hepatic curve（T4）.The time of gastroenteroscopy,the dosage of propofol and the recovery time were recorded.The occurrence of adverse reactions（injection pain,body movement,respiratory depression,hypotension,bradycardia）and postoperative adverse reactions（nausea and vomiting,respiratory depression,headache and dizziness）were recorded.Results:1.There was no significant difference in the basic situation of the four groups（P > 0.05）.2.There was no significant difference in the whole time of gastroenteroscopy among the four groups（P > 0.05）.The dosage of propofol in S1,S2 and S3 groups was significantly lower than that in D group（P < 0.05）,but there was no significant difference in the dosage of propofol in S1,S2 and S3 groups（P > 0.05）.Compared with the time from the end of gastroenteroscopy to the complete awakening of patients,the complete awakening time of S1,S2 and S3 groups was significantly shorter than that of group D（P < 0.05）,while the complete awakening time of S2 and S3 groups was shorter than that of group A（P < 0.05）.There was no significant difference between group B and C（P > 0.05）.3.Comparison of relevant vital sign parameters: there was no statistical significance in the comparison of map,HR and Sp O2 at t0 in the four groups（P >0.05）.At T1 and T3,the HR of group D was significantly faster than that of group S3（P < 0.05）,at T2,the HR of group D was significantly faster than that of groups S1,S2 and S3（P < 0.05）,and at T4,the map and HR of group D were also significantly higher than those of groups S2 and S3（P < 0.05）;In group D,the map and HR of T1,T2,T3 and T4 were significantly lower than those of to（P < 0.05）,the map of T2,T3 and T4 was significantly higher than that of T1（P < 0.05）,the Sp O2 of T1 was significantly lower than that of T3 and T4（P < 0.05）,and the map and HR of T4 were significantly higher than those of T2 and T3（P < 0.05）;In S1 group,except that the HR of T4 was not significantly different from that of t0（P > 0.05）,map and HR at each point fluctuated significantly with the change of broken line chart（P < 0.05）;In S2 and S3 groups,the map and HR of T1,T2,T3 and T4 were significantly lower than those of to（P < 0.05）,the map and HR of T3 were significantly higher than those of T1（P < 0.05）,the map and HR of T4 were significantly higher than those of T1,T2 and T3（P < 0.05）,the HR of T3 in S3 group was significantly faster than that of T2（P< 0.05）,and the Sp O2 of T1 was significantly lower than that of T0,T2,T3 and T4（P< 0.05）.4.Comparison of related adverse reactions: in each group,the incidence of adverse reactions in group D was significantly higher than that in S2 and S3（P <0.05）,and the incidence of other intraoperative adverse reactions had no statistical significance（P > 0.05）.There was no significant difference in the incidence of postoperative adverse reactions between the groups（P > 0.05）.Conclusion:In conclusion,oxycodone combined with propofol can safely.In order to carry out painless gastroenteroscopy anesthesia,oxycodone 0.08mg/kg is the most reasonable dosage.Under this dosage,propofol is used less,and the incidence of intraoperative and postoperative adverse reactions is low.Patients wake up quickly,which can be popularized in clinical application. |
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