Comparison Of Nasal Dexmedetomidine And Intravenous Propofol For Painless Gastroscopy Anesthesia In Elderly Patients

Objective To compare the clinical efficacy and safety of nasal Dexmedetomidine and intravenous propofol for Painless Gastroscopy Anesthesia in Elderly Patients.Methods In total 120 elderly patients(?70 years old)with painless gastroscopy from October 2018 to December 2018 were enrolled in the study.They were randomly divided into control group,low dose group and high dose group(40 cases in each).In the control group,1.5 mg/kg propofol was administered intravenously before the Gastroscopy.Dexmedetomidine 0.5 ug/kg(low dose group)or 1 ug/kg(high dose group)were given by intranasal administration respectively 30 min before Gastroscopy in the study groups.The blood pressure(BP),heart rate(HR),and pulse oxygen saturation(SpO2)of the patients in the three groups after entering the room(T1),at the beginning(T2)and the end of the examination(T3)were observed.The patient's sedation score,recovery time,adverse reactions,and operator satisfaction were recorded and compared.Results Diastolic blood pressure,Systolic blood pressure and mean arterial pressure in three groups decreased with the time going on,but the low-dose group and high-dose group were higher than the control group at T2 and T3,the difference was statistically significant(P<0.0001);the oxygen saturation of the low-dose group and the high-dose group were higher than the control group at T2,and there was no difference among the three groups at T3(P<0.0001);the recovery time and sedation score in low-dose group and high-dose group were lower than that of the control group(P<0.0001),but there were no significant differences between low-dose group and high-dose group;the incidence of adverse reactions in high-dose group was lower than that of the control group and low-dose group(P<0.0001),the operator satisfaction was higher than two other groups(P<0.0001),but there were no significant differences in low-dose group and control group.Conclusion Compared with intravenous propofol,Dexmedetomidine 1 ug/kg was given by intranasal administration is an ideal anesthesia program and worthy of clinical promotion for elderly patients undergoing gastroscopy,which is easier to operate,has good sedation,a lower incidence of adverse reactions and higher safety.