Propofol target-controlled infusion combined with remifentanil for small intestinal endoscopy / 医学研究生学报

ABSTRACT

Objective: To explore the reasonable compatibility of anesthetics in painless small intestinal endoscopy by comparing the influence of different target plasma propofol concentrations combined with remifentanil on anesthesia effects and respiratory and circulatory functions.Methods: Two hundred patients requiring small intestinal endoscopy were randomly divided into 4 groups,Group Ⅰ given 1% propofol only,with the target plasma propofol concentration set at 4.5 ?g/ml,and Group Ⅱ,Ⅲ and Ⅳ receiving 30-second injection of remifentanil(0.3 ?g/kg) 1 min before target-controlled infusion(TCI) of propofol,with the target plasma propofol concentration set at 3.0,3.5 and 4.0 ?g/ml,respectively.The mean arterial pressure(MAP),heart rate(HR),pulse oxygenation(SpO2),induction time,awakening time,orientation recovery time and the incidence of patients' body motion were observed before anesthesia,at the vanishment of the eyelash reflex,while the small intestine endoscope passing through the Treitz ligament or ileoceal valve and after endoscopy.Results: Compared with baseline values,MAP and HR were significantly decreased in all groups when the eyelash reflex vanished,markedly increased in Group Ⅰ,although not so obvious in Groups Ⅱ and Ⅲ,when the small intestinal endoscope passed through the Treitz ligament or ileoceal valve,and greatly reduced at all time points in Group Ⅳ,with difficult entrance of the small intestine endoscope due to low tension of the intestinal cavity.Comparatively,the induction time was shorter and the awakening time and orientation recovery time were longer in Group Ⅰ,the total dose of propofol and the incidence of body motion notably decreased in Groups Ⅱand Ⅲ,and the incidence of respiratory depression obviously increased in Group Ⅳ.Conclusion: Propofol TCI combined with remifentanil can be used safely and effectively in painless small intestinal endoscopy.Target plasma propofol concentration(3.5 ?g/ml) in combination with remifentanil(0.3 ?g/kg) gives more efficient anesthesia,lower incidence of body motion and respiratory suppression and better recovery.Therefore,it is the suitable anesthetic compatibility in painless small intestinal endoscopy.