| Objective To compare the clinical effect of propofol combined with esketamine or remifentanil in endoscopic retrograde cholangiopancreatography anesthesia.Methods A total of 80 patients undergoing endoscopic retrograde cholangiopancreatography under general anesthesia in the Affiliated Hospital of Yanbian University from March 2021 to November 2021 were randomly divided into two groups: ketamine group(group S)and remifentanil group(group R).In the group S,0.5mg/kg estazolam and 1.5–2 mg/kg propofol were intravenously injected for anesthesia induction,and 0.5mg/kg/h estazolam and 1% propofol 5mg/kg/h were intravenously pumped for anesthesia maintenance.Group R was anesthetized and induced by intravenous remifentanil 0.5ug/kg and% propofol 1.5–2 mg/kg,and maintained by intravenous pump remifentanil 6ug/kg/h and 1% propofol 5 mg/kg/h.All medications were also discontinued at the end of the procedure.The heart rate,blood pressure,mean arterial pressure,and oxyhemoglobin saturation of the patients in the two groups were observed and recorded at six time points,respectively:entering the room(T0),The eyelash reflex disappeared after anesthesia induction(T1),surgical operation(T2),Endoscopy was performed into the duodenal papilla(T3),anesthesia awakening(T4),and exiting the room(T5).The operation time and anesthesia awakening time of patients were recorded.The additional dose of propofol during the operation was observed and recorded,as well as the incidence of complications such as body movement,cough and nausea and vomiting after awakening.Results There was no significant difference in general conditions between the two groups(P > 0.05).Comparison of MAP between the two groups: MAP in group R decreased more sharply than that in group S after anesthesia began,and MAP in both groups increased transiently at T2 and T3,but the fluctuation amplitude in group R was still larger than that in group S.MAP in the two groups recovered to the basic level after patients awoke.The changes of MAP fluctuated significantly at multiple time points,with statistical significance(P < 0.05).Comparison of Sp O2 between the two groups: There was a difference in the Sp O2 over time between the group R and the group S,but no statistical significance(P > 0.05).In the comparison of awakening time,that is,T5,the awakening time in group R was longer than that in group S,and the difference was statistically significant(P < 0.05).There was no statistical difference in the incidence of complications such as propofol addition,body movement,cough,and nausea after awakening between the two groups(P >0.05).Conclusion In ERCP surgery,propofol combined with esketamine or remifentanil anesthesia can provide safe and good anesthesia effect for patients.However,propofol combined with esketamine has greater significance and advantages in maintaining hemodynamic stability of patients. |
