Effect Of Propofol Used For Outpatient Painless Gastrointestinal Endoscope On Early Postoperative Cognitive Function Of Elder Patients

0bjective:To study the effect of painless gastrointestinal endoscope on the early postoperative cognitive function of elder patients by using propofol alone.Methods:A total of 200 cases of outpatients?ASA I to??scheduled for elective painless gastrointestinal endoscope,divided into the young age group?18⁶4 years old,n₁=100?and the elderly group?65 years old and above,n₂=100?.Two groups of patients were injected with 1%propofol1.5².0mg/kg before endoscopy or enteroscopy.The gastrocoloscope was inserted when the the patients^'eyelash reflex disappeared and the Observer^'s Assessment of Alertness/Sedation Scale,OAA/S?2levels.That is to say the gastrocoloscope was inserted when patients showed unconsciousness and no reaction to dictation.Keep SPO₂%more than95%during the examination.All patients received the Mini-Mental State Examination,MMSE before anaesthesia?T0?and after waking up5minutes?T1?,30minutes?T2?,3hours?T3?,6hours?T4?when the gastrocoloscope examination was over and the patients recovered consciousness.The changes of MMSE scores and early cognitive function at different time points were compared between the two groups.Results:All patients completed gastroscopy or colonoscopy and received MMSE to assess cognitive function.1.The difference of the total dosage of propofol in the two groups had statistical significance?P<0.05?.The total dosage of propofol in the young and middle-aged group was more than that in the elderly group,but there was no statistically significant difference between the two groups in the time of inspection and wakefulness time?P>0.05?.2.Compared to the two groups before and after medication,the differences of the mean arterial pressure,blood oxygen saturation had no statistical significance?P>0.05?,the difference of the heart rate had statistical significance?P<0.05?,the heart rate of the elderly group was lower than that of the young and middle-aged group before and after the medication.The differences of mean arterial pressure,heart rate and blood oxygen saturation had statistical significance?P<0.05?before and after the medication,respectively,in the two groups.The mean arterial pressure and heart rate after the medication were significantly lower than those before the medication,and the blood oxygen saturation was increased in the case of oxygen inhalation.3.Compared to the two groups,the differences of the MMSE scores of T0 and T1,T2,T3 and T4 had statistical significance?P<0.05?,The MMSE scores of the young and middle-aged group at different time points before surgery and after awake were all higher than those in the elderly group,that is to say,the cognitive function of the young and middle-aged group was better than that of the elderly group at different time points before and after operation.The two groups respectively to compare the MMSE scores in T0 and T1,T2,T3 and T4.The differences between the scores of T0 and T1 in both groups had no statistical significance?P>0.05?,while,in the elderly group,the difference between the scores of T0 and T1had statistical significance?P<0.05?,the score of T1 was higher than the score of T0,and in the young and middle-aged group,the difference between the scores of T0 and T4 had statistical significance?P<0.05?,the score of T4 was also higher than the score of T0.4.The sedative effect of the two groups was excellent?96 cases in the young and middle-aged group,98 cases in the elderly group?or good,the difference had no statistical significance?P>0.05?.The satisfaction of the two groups was 100%.In the both two groups,9 cases had adverse reactions such as body movement,hypotension and bradycardia,and the difference had no statistical significance?P>0.05?.Conclusion:The application of propofol for painless gastrointestinal endoscopy examination in elderly patients can not only provide satisfactory sedative effect and good examination condition,but also has no obvious effect on the early postoperative cognitive function of the elderly patients,but the total dosage of propofol in the elderly patients is less than that in the young and middle-aged patients.