Clinical Observation Of Different Doses Of Oxycodone In Patients With Chronic Liver Disease Undergoing Painless Gastroscopy

Objectives Chronic liver disease,if not actively treated,would typically evolve into cirrhosis,where esophageal variceal bleeding could be a very severe complication.It is therefore a common clinical practice to diagnose whether there is concurrent varicosity by gastroscopy.Gastroscopy is one of the commonly used method for examination of the digestive system,however,its invasive nature causes fear,pain,and discomfort to patients,which are manifested as nausea,vomiting,high blood pressure,and body movement.Painless gastroscopy reduces the patient's anxiety and fear and improves patient compliance and tolerability,and thus has been widely used and highly valued.Sedative and analgesic drugs are often used to put the patient in a light sleep state during painless gastroscopy,allowing better tolerance and higher compliance.Propofol injection is commonly used for sedation,and opioids,such as Fentanyl family of drugs,for analgesia.Oxycodone hydrochloride is a commonly used dual-opioid receptor agonist for both ? and ? receptors,which shows high affinity for ? receptors of the internal organs and has been proved effective in relieving visceral pain.This study was designed to investigate the appropriate dose of oxycodone hydrochloride in patients with chronic liver disease undergoing painless gastroscopy in clinical practice.Methods One hundred and twenty ASA grade II patients with chronic liver disease undergoing outpatient painless gastroscopy were randomly divided into 4 groups,each including 30 patients: experimental groups Q1,Q2,Q3 that received different doses of oxycodone,and a control group P.1.Anesthesia: Venous access was prepared and the monitor was connected when the patient enters the endoscopy chamber.ECG,non-invasive arterial pressure,respiration,and oxygen saturation were routinely monitored during the surgery.The experimental groups Q1,Q2,Q3 were intravenously injected with oxycodone hydrochloride at 0.025mg/kg,0.05mg/kg,0.1mg/kg respectively,followed by intravenous injection of Propofol at 2mg/kg 2 minutes later,while the P group were given only the same dose of Propofol.Painless gastroscopy was performed after disappearance of the patients' eyelash reflex.2.Data collection: operation time,time to complete recovery,amount of Propofol usage during the operation,occurrence of hypotension,bradycardia,respiratory depression,body motion and nausea,vomiting and other adverse reactions were recorded.And blood pressure,heart rate,respiratory,blood oxygen saturation changes of the 4 groups were observe and recorded before anesthesia(T0,equivalent to baseline values),when eyelash reflexes disappeared(T1),1min after successful mirror placement(T2),when taking out the mirror(T3),and when the patient walks again(T4).3.Statistical analysis: SPSS13.0 software was presented as mean±SD;t test was used for comparison between groups;repeated measures ANOVA was used for comparison within a group;?2 test was used for comparison of categorical variables;a difference was considered statistically significant at P<0.05.Results 1.There were no significant difference in general conditions among the 4 groups(P>0.05).2.There were no significant difference in time to complete recovery among Q1,Q2 and Q3 groups(P>0.05),but the time was shorter in all three experimental groups Q1,Q2,and Q3 than in the control group P(P<0.05).The doses of Propofol use were lower in the experimental groups than in the control group(P<0.05),and reversely correlated with dose of oxycodone Q1>Q2>Q3.3.Comparison of related vital signs:Compared to T0,there were no significant changes in Sp O2 at T1-T4 in any groups(p>0.05),and the Sp O2 remained within the reference range in all the groups;at T1-T3,MAP and HR were significantly reduced in the Oxycodone groups,with statistically significant differences(p<0.05).4.Adverse reactions: 1 case of hypotension,1 case of respiratory depression,1 case of nausea and vomiting,and 2 cases of body movement in Group Q2;2 cases of respiratory depression and 4 cases of nausea and vomiting in Group Q3.The incidence of adverse reactions was lower in Group Q2 than in Group Q3(p<0.05)...Conclusions Oxycodone 0.05mg/kg combined with propofol is associated with less adverse reactions,requires lower dose of Propofol,and reduces the recovery time,suggesting its applicability in patients with chronic liver disease undergoing painless gastroscopy with favorable safety profile.