Dezocine And Fentanyl For Middle-aged Retrograde Endoscopic Retrograde Chofangio-Pancreatography Comparison Of The Effects

Objective:To investigate dezocine ERCP surgery in the elderly in theapplication, to prevent body movement, cough, respiratory depression,and the occurrence of the reaction during ERCP procedure. Thus toprovide a reference for clinical work.Method:80Patients undergoing endoscopic retrograde cholangiopancreatography (ERCP), stonetaken were selected in First Clinical Hospital ofJilin University during November2011–March2012. ASA Ⅰ~Ⅱlevelpatients without severe heart and lung disease including52males and28females; age (62to82) years; weight (55~~85) kg.80cases subjectswere randomly divided into two groups, Group A:propofol and fentanyl,Group B:propofol compound dezocine.Preoperative food and water deprivation8~~10h the preoperative20min intramuscular atropine0.5mg, sit-in a break of10to15min theanesthesia monitor continuous monitoring of the electrocardiogram (ECG)is connected to the patient after entering operating room, mean arterialpressure (MAP), heart rate (HR), respiratory frequency (RR), pulseoximetry degrees (SpO2) were monitored, establishment of intravenous access line prone position were made and nasal cannula oxygeninhalation were supplied, abdomen and chest put a thin pad to ensureunobstructed breathing, during the treatment process, oxygen flow2~5L/min were supplied. ERCP treatment group A intravenous midazolam1mg and propofol1.5mg/kg with fentanyl0.015mg/kg, micro pump,propofol4to8mg/kg/h to maintain anesthesia.Anesthesia was maintained: ERCP treatment group B intravenousmidazolam1mg propofol1.5mg/kg and dezocine0.1~~0.2mg/kg.after induction, connect micro pump, maintain anesthesia with propofol4~8mg/kg/h administered after induction penehyclidine0.5mg. afterpatient awareness completely disappear, should start the surgery. Whenintraoperative SpO2<90%, stop the surgical operation, jaw line maskpressurized oxygen assisted ventilation. When HR <50times/min, andMAP <60mmHg, atropine and dopamine were used. When endoscopicwere sustained, stop giving anesthetics drugs and intraoperative standingoropharyngeal airway, breathing bag.Records from the withdrawal of awake time to eye opening, truthfullyrecorded throughout the surgery and the incidence of adversepostoperative two groups of patients with nausea, vomiting, cough, bodymovement.Experimental results: Both groups of patients are able tosuccessfully complete the ERCP examination. Two sets of surgery time 40~60min, there was no significant difference (P>0.05). Group Awake-up time is greater than in group B (P <0.05), and propofol tomaintain approximately the same amount in Group A and B, and has nostatistically difference (P>0.05). Table1. Patients at each time point HR,MAP, RR, SpO2change in each group are shown in Table2; MAP andRR of Patients in Group A are lower than those in Group B afterinduction (P <0.05). The incidence of adverse reactions in group A wassignificantly greater than in group B, in Table1to Table3.Conclusion:propofol combined dezocine closer to the above characteristics,which has a wide-ranging effects of anesthesia in elderly patientsundergoing ERCP surgery. In this method, patients have stablerespiratory and circulatory, low incidence of adverse reactions. And hasgood security worthy of clinical application.