Study On The Influence Of Age And Gender On The Sedative And Analgesic Effect Of Nitrous Oxide During Gastroscopy

Background&ObjectiveMany studies have pointed out that inhalation of nitrous oxide(N2O)has good sedative and analgesic effects in gastroscopy,but there is no study on the difference of sedative and analgesic effects of N2O among different populations at home and abroad.The purpose of this study was to compare the sedative and analgesic effects of N2O in patients of different ages and genders in gastroscopy,to comprehensively explore the influencing factors of sedative and analgesic effects of N2O,and to evaluate the safety of the conscious sedation and analgesic process of N2O.MethodsFrom March 2017 to July 2018,311 patients who underwent conscious sedation and analgesic gastroscopy with N2O in the digestive endoscopy center of the third affiliated hospital of southern medical university were selected as the study subjects,and were divided into the youth group,the middle-aged group and the elderly group according to their age.It is also divided into male group and female group according to gender.The data of ideal concentration of N2O,ideal time of N20,Ramsay sedation level,VAS pain score,comfort level and adverse reactions were recorded respectively,and comparative analysis was conducted according to different age groups and gender groups.Age,sex,BMI,history of excessive drinking,history of excessive smoking and ASA classification were included in univariate and multivariate analysis to explore the influencing factors of sedative and analgesic effects of N2O.The heart rate,blood pressure and blood oxygen saturation of the patients before the inhalation of N2O(T1),during the inhalation of N2O(T2)and after the inhalation of N2O(T3)were collected to evaluate the safety of the conscious sedation and analgesic process of N2O.Results1.Comparison of baseline data among patients:There were no significant differences in gender,BMI,history of excessive drinking,history of excessive smoking and ASA classification among patients in different age groups(P>0.05).There were no significant differences in average age,BMI,history of excessive drinking,history of excessive smoking and ASA classification among patients in different gender groups(P>0.05).2.Comparison of sedative and analgesic effects of N2O in different age groups and gender groups:?Compared with the young and middle-aged group,the elderly group had a smaller ideal concentration of N2O(P<0.05),a shorter ideal time of N20(P<0.05),higher Ramsay sedation level(P<0.05),lower VAS pain score(P<0.05),better comfort level(P<0.05),and lower overall incidence of adverse reactions(P<0.05).?Compared with the male group,the female group had a smaller ideal concentration of N2O(P<0.05),a shorter ideal time of N2O(P<0,05),higher Ramsay sedation level(P<0.05),lower VAS pain score(P<0.05),and better comfort level(P<0.05).3.Influencing factor analysis of sedative and analgesic effects of N2O:?Single factor analysis showed that age and gender were related to sedative and analgesic effects of N2O.?Multiple-factor analysis showed that young,middle-aged and male were independent risk factors affecting the sedative and analgesic effects of N20.4.Safety analysis of the conscious sedation and analgesic process of N2O:4.1 Changes in heart rate:The heart rate of the patient at time T2 was significantly higher than T1 and T3(P<0.05),and T3 was significantly higher than T1(P<0.05).4.2 Changes in blood pressure:The systolic and diastolic blood pressures of the patient at time T2 were significantly higher than T1 and T3(P<0.05),while T1 and T3 showed no statistical difference(P>0.05).4.3 Changes in blood oxygen saturation:There was no statistical difference in blood oxygen saturation between the patients at T1,T2 and T3(P>0.05).Conclusion1.Age and gender are important influencing factors for the sedative and analgesic effect of N2O in gastroscopy,and young people,middle-aged people and men are independent risk factors for the sedative and analgesic effect of N2O.Elderly patients and female patients are more likely to achieve the ideal anesthesia state and the sedative and analgesic effect of N2O are better.2.The conscious sedation and analgesic process of N2O has no obvious inhibitory effect on patients'respiration and hemodynamics,so it is safe for gastroscopy.For elderly patients and female patients,the comfortable gastroscopy with N2O can be used selectively according to the actual situation.