Effects Of Propofol Combined Etomidate On The Perfusion Index Of Elderly Patients With Gastroscopy

AbstractObjective: The aim of this study is to investgate the peripheral perfusion changes of propofol combined etomidate of elderly patients undergoing analgesia gastroscopy during the induction period and then evaluate the safety of the application of propofol combined with etomidate.Method:200 elderly patients aged from 65 to 80 years old examinated by analgesia gastroscopy with ASA?-of outpatient were selected?,according to the random number table method,they were randomly divided into5 groups: Propofol group(P group),Etomidate group(E group),Propofol combined with Etomidate group(PE group),Etomidate combined with Propofol group(EP group),Mixture group(M group).40 cases in each group.The cases of P group were injected with2 mg/kg of propofol.The cases of E group were injected with0.4 mg/ kg of etomidate.The cases of PE group were injected with1 mg/ kg of propofol and after a few seconds0.2 mg/ kg of etomidate was added.The cases of EP group were injected with0.2 mg/ kg of etomidate and after a few seconds1 mg/ kg of propofol was added.The cases of M group were injected with1 mg/ kg of propofol plus0.2 mg/ kg of etomidate mixture.The operation of gastroscopy started when patient' s eyelash reflex disappeared.The peripheral perfusion index(PI)changes,mean arterial pressure(MAP)changes,heart rate(HR)changes,hypoxemia(SPO2<90%),the time interval between the induction and addition,injection pain,muscle twitching were observed.Result: The decrease of PI in P group was significantly greater than E group(P<0.001),and the decrease of PI in PE,EP and M group was significantly lower than that in P group(P<0.05).The decrease of MAP in P group was most significant,and PE,EP and M group were significantly better compared with P group(P<0.05).The decrease of heart rate was largest in P group,and data of E group was the smallest.The HR of EP group,M group and P group were both significantly different from P group(P<0.05).There were15 cases of hypoxemia in P group and only6 in M group,which the improvement was obvious(P<0.05).There was no significant difference of the time interval between P group and PE,EP,M groups(P>0.05).In P group,there were 12 cases of injection pain while E group and EP group were lowest(only 2 cases).The cases in EP group and M group were significantly fewer compared with P group(P<0.05).In E group,there were15 cases of muscle twitching while PE group,EP group and M group all significantly reduced the occurrence of muscle twitching(P<0.05).Among all the results,there was no significant difference between PE group,EP group and M group(P>0.05).Conclusion: Propofol combined with etomidate set the advantages of each drug.It has a small impact on the peripheral perfusion index and stabilize the hemodynamics of elderly patients.At the same time,it reduce the incidence rates of adverse reactions.Propofol combined with etomidate is suitable for elderly patients undergoing analgesia gastroscopy.Propofol plus etomidate or etomidate plus propofol show no difference in various effects.The usage of propofol plus etomidate mixture not only reduce the dosage of the each drug diluting concentration which is better in maintaining the spontaneous breathing.