| Objective Colonoscopy can clearly examine the interior of the whole rectum and perform pathological biopsy.these advantages make colonoscopy become the gold standard for the diagnosis of colorectal cancer,but endoscopic procedures often make patients feel uncomfortable and even cause cardiovascular accidents in elderly patients.Therefore,painless enteroscopy is often used to examine the elderly patients in order to reduce the pain and reduce the incidence of adverse events such as cardiac and cerebrovascular events.As an opioid drug,compared with equivalent doses of fentanyl and sufentanil,alfentanil has the advantages of rapid effect,rapid recovery,respiratory depression and low incidence of postoperative nausea and vomiting.it is more suitable for painless endoscopy in elderly patients.In this study,sufentanil was used as control to compare the anesthetic effects of three different doses of afentanil in elderly patients undergoing painless enteroscopy and their effects on recovery quality,so as to provide reference for clinical use.Methods From June 2021 to June 2022,200 elderly patients who needed painless enteroscopy in Chaohu Hospital affiliated to Anhui Medical University were selected as subjects,aged 65~79 years、BMI18-30kg/m2、ASA gradeⅠ~Ⅲ.They were randomly divided into four groups: sufentanil group(group S),low dose group(group A1),middle dose group(group A2)and high dose group(group A3).Before enteroscopy,group S was injected with sufentanil 0.1μg / kg,group A1、A2 and A3 were injected with 5μg / kg,7.5μg / kg and 10μg / kg of sufentanil respectively,followed by propofol 1.5mg/kg until the eyelash reflex disappeared.The values of HR,MAP,Sp O2 and BIS were recorded before administration(T0),when the eyelash reflex disappeared(T1),when the hepatic flexure of the colon was passed(T2)and when the microscopic examination was completed(T3).At the same time,the total dosage of propofol,eye opening time,orientation recovery time,colonoscopy operation time,and adverse reactions such as cough,body movement,postoperative nausea,vomiting and dizziness were recorded.Results(1)There was no significant difference in sex,age,body weight,BMI,ASA and gastroscope operation time among the four groups.(2)At T2,the blood pressure and heart rate in group A1 were significantly higher than those in group A2,group A3 and group S.The dosage of propofol in group A1 was significantly higher than that in group A2,group A3 and group S.At T1,the decrease of Sp O2 in S group and A3 group was more obvious than that in A1 group and A2 group.(3)The recovery time and orientation recovery time of 3.A1,A2 and A3 groups were significantly shorter than those of S group,and the incidences of cough,postoperative nausea and dizziness were lower.Conclusion At the equivalent analgesic dose,alfentanil combined with propofol can be safely and effectively used in painless enteroscopy,and compared with sufentanil,the time of onset,awakening and orientation recovery is faster,and the total incidence of adverse reactions is less.The appropriate dose is 7.5μg/kg. |
