Comparison of dexmedetomidine and sufentanil combined with propofol for deep sedation undergoing endoscopic retrograde cholangiopancreatography in elderly patients / 临床麻醉学杂志

ABSTRACT

Objective To compare the sedative efficacy and safety of dexmedetomidine and sufen-tanil combined with propofol in elderly patients undergoing endoscopic retrograde cholangiopancreatography(ERCP).Methods Sixty elderly patients from July to October 2022,aged 65-90 years,BMI 15-33 kg/m2,ASA physical status Ⅰ-Ⅲ,had normal cardiac function or NHYA grade Ⅰ or Ⅱ,underwent ERCP were enrolled.Patients were divided into two groups by random number table method:the dexmedeto-midine group(group D)and the sufentanil group(group S),30 patients in each group.Group D received an intravenous infusion of dexmedetomidine 0.5 μg/kg for 10 minutes followed by intravenous propofol 1 mg/kg for sedation induction.Group S received intravenous sufentanil 0.12 μg/kg followed by intravenous propofol 1 mg/kg for sedation induction.The operation time,total dosage of propofol,incidence of body movement were recorded.The lowest SpO2,use of airway interventions,incidence of hypoxemia were recor-ded.Adverse cardiovascular events(tachycardia,bradycardia,hypertension,hypotension,and arrhythmia)were recorded.Awakening time,VAS pain scores at rest 15 minutes after entering PACU,incidence of mod-erate to severe postoperative pain,and postoperative nausea and vomiting in PACU were recorded.Results Adequate deep sedation was successfully achieved in the two groups(Ramsay scale≥5 scores).Compared with group S,the lowest SpO2 and bradycardia were significantly increased(P＜0.05),the use of airway interventions,hypoxemia,tachycardia,and hypotension were significantly decreased in group D(P＜0.05).There were no significant differences in operation time,total dosage of propofol,incidence of body movement,hypertension,VAS pain scores at rest 15 minutes after entering PACU,moderate to severe post-operative pain,and postoperative nausea and vomiting in PACU between the two groups.Conclusion Dexmedetomidine or sufentanil combined with propofol can provide adequate deep sedation for ERCP proce-dure.Dexmedetomidine combined with propofol can keep intraoperative cardiovascular function more stable,and reduce the occurrence of intraoperative hypoxemia and cardiovascular adverse events.