Clinical Study Of Lidocaine Combined With Propofol In Multi-ethnic Painless Gastroscopy In Yunnan Province

Background and Objective:To observe the clinical application effect of lidocaine combined with propofol in painless gastroscopy for patients of different ethnic groups in Yunnan Province in a prospective manner,and to explore the dose differences of anesthetic drugs required by Han ethnic group,Bai ethnic group,Yi ethnic group,Tibetan ethnic group and Lisu ethnic group,so as to provide clinical reference for individualized anesthetic drug use among different ethnic groups in Yunnan Province.It also provides more reference ways for different ethnic patients in Yunnan province in painless gastroscopy individualized anesthesia program.Methods:A total of 150 patients from different ethnic groups who underwent elective painless gastroscopy in the First Affiliated Hospital of Dali University from November 2021 to May 2022 were selected and divided into the Han group（H group,n=30）,Bai group（B group,n=30）,Yi group（Y group,n=30）,Tibetan group（Z group,n=30）and Lisu group（L group,n=30）.The proportions of intravenous anesthesia drug complex solution in the five groups were as follows:1.Midazolam-fentanyl complex solution（midazolam 10mg/2ml+Fentanyl 0.9mg/18ml,total 20ml;2.Midazolam content 0.5mg/ml,Fentanyl content 0.045mg/ml）;2.Lidocaine-propofol complex liquid（lidocaine 60mg/3ml+propofol 200mg/20ml,total 23ml;Lidocaine content 2.6mg/ml,propofol content 8.7mg/ml）.All patients were injected with0.02ml/kg intravenous infusion of midazolam-Fentanyl complex solution,followed by intravenous infusion of 0.13ml/kg lidocaine-propofol complex solution for anesthesia induction,and the above doses were explored with the previous trial dose.Observation contents of this study:（1）The total dose of propofol,the total dose of lidocaine,the total dose of fentanyl,and the total dose of midazolam were recorded in the five groups.（2）The operation time of gastroscope（the time from the beginning of gastroscope to the end of gastroscope to the end of gastroscope to the end of gastroscope to the end of gastroscope to the end of gastroscope to the end of gastroscope to the end of gastroscope to the end of the patients’eyes）,the time of leaving the resuscitation room(the time from the end of gastroscope to the time of patients meeting the discharge criteria,（3）The changes of Sp O2,SBP,DBP and HR after admission（T1）,immediately after admission（T2）,during gastroscopy operation（T3）and at the end of gastroscopy operation（T4）were recorded.（4）The occurrence of pain after propofol injection,adverse events（somokinetic reaction,respiratory depression,hypotension,bradycardia,cough,nausea and vomiting,etc.）during and after gastroscopy were recorded.Results:（1）There were no significant differences in the general information of age,gender,BMI and ASA classification among the five groups（P>0.05）.The total dosage of propofol was statistically different among the five groups(^ΔΔΔP<0.001).Compared with groups Z and L,the total dose of propofol in group H was significantly lower(^ΔΔΔP<0.001).The total dose of propofol in group H was lower than that in group Y(^ΔΔP<0.01).There was no statistical difference in the dosage of propofol between group H and group B（P>0.05）.The total dose of propofol in group B was significantly lower than that in group Z(^ΔΔΔP<0.001).Compared with Y and L groups,the total dose of propofol in group B was lower（^ΔP<0.05）.Compared with group Z and L,the total dose of propofol in group Y had no statistical difference（P>0.05）.The total dose of lidocaine was statistically different among the five groups(^ΔΔΔP<0.001).The total dose of lidocaine in group H was significantly lower than that in groups Y,Z and L(^ΔΔΔP<0.001).There was no significant difference in the total dose of lidocaine between group H and group B（P>0.05）.The total dose of lidocaine in group B was significantly lower than that in group Z(^ΔΔΔP<0.001).Compared with Y and L groups,the total dose of lidocaine in group B was lower（^ΔP<0.05）.There was no statistical difference in the total dose of lidocaine in group Y compared with group Z and Group L（P>0.05）.There were no significant differences in gastroscopy time,recovery time and time to leave resuscitation room among the five groups（P>0.05）.Changes of vital signs in 5 groups at different time points:Sp O2 in group L and group Z at T2 was significantly lower than that in group H,group B and group Y（P<0.05）;Sp O2 in group H was significantly lower than that in groups B,Y,Z and L at T3（P<0.05）.The HR of group B at T2 was significantly higher than that of group H,Y,Z and L（P<0.05）.There were no significant differences in Sp O2,HR,SBP and DBP among other groups and at each time point（P>0.05）.There was no significant difference in the incidence of perioperative adverse reactions among the five groups（P>0.05）.Conclusions:1.The demand of propofol dose of Yi,Tibetan and Lisu ethnic groups in Yunnan Province is greater than that of Han and Bai;2.Group differences among Han,Bai,Yi,Tibetan and Lisu should be considered in clinical application of propofol drug,and individualized drug use;3.Lidocaine combined with propofol in painless gastroscopy has a low incidence of adverse reactions and stable hemodynamics,which is worthy of clinical promotion and application.