Original Article
Safety of Propofol combined with Fentanyl in intravenous anesthesia for endoscopic retrograde cholangiopancreatography in elderly patients
Jihua Shi, Xiaoyun Qin, Rui Gang, Haimeng Cui, Hai Li, Qingfeng Luo
Published 2019-06-14
Cite as Chin J Geriatr, 2019, 38(6): 658-661. DOI: 10.3760/cma.j.issn.0254-9026.2019.06.015
Abstract
ObjectiveTo evaluate the safety of Propofol combined with Fentanyl in intravenous anesthesia for endoscopic retrograde cholangiopancreatography(ERCP)in elderly patients.
MethodsThe clinical data of 63 elderly patients aged ≥80 years with common bile duct stones who underwent ERCP in digestive endoscopy center of our hospital were retrospectively analyzed.All the patients were divided into Propofol combined with Fentanyl anesthesia group(group A, n=41)and midazolam combined with Fentanyl anesthesia group(group B, n=22). The changes of blood pressure, heart rate and blood oxygen saturation(SpO2), and postoperative complications were compared between the two groups.
ResultsThe incidence of hypotension was higher in Propofol combined with Fentanyl anesthesia group than in midazolam combined with Fentanyl anesthesia group(24.4% vs.0.0%, χ2=4.683, P=0.030), but the incidence of SpO2 < 90% in midazolam combined with fentanyl anesthesia group was significantly increased(22.7% vs.0.0%, χ2=7.250, P=0.007). There was no statistically significant difference in the incidence of anesthesia-related complications(39.0% vs.36.4%, χ2=0.043, P=0.836)and postoperative complications(4.9% vs.4.5%, χ2=0.003, P=0.953)between the two groups.
ConclusionsFor elderly patients with common bile duct stones, intravenous anesthesia with Propofol and Fentanyl during ERCP is safe, and blood pressure changes need to be closely monitored.
Key words:
Cholangiopancreatography, endoscopic retrograde; Choledocholithiasis; Propofol
Contributor Information
Jihua Shi
Department of Gastroenterology, Beijing Hospital, National Center of Gerontology, Beijing 100730, China
Xiaoyun Qin
Department of Gastroenterology, Beijing Hospital, National Center of Gerontology, Beijing 100730, China
Rui Gang
Department of Gastroenterology, Beijing Hospital, National Center of Gerontology, Beijing 100730, China
Haimeng Cui
Department of Gastroenterology, Beijing Hospital, National Center of Gerontology, Beijing 100730, China
Hai Li
Department of Anesthesiology, Beijing Hospital, National Center of Gerontology, Beijing 100730, China
Qingfeng Luo
Department of Gastroenterology, Beijing Hospital, National Center of Gerontology, Beijing 100730, China
类联合哌替啶，但存在患者耐受性差导致ERCP手术失败或反复多次ERCP的问题[1]。近些年，越来越多的研究表明在ERCP过程中联合使用咪达唑仑和丙泊酚麻醉比单独使用咪达唑仑更有效，且在检查的安全性方面无差异[2,3]。我院多数患者ERCP术中采用以丙泊酚为基础的全身静脉麻醉方式，本研究回顾性分析我院高龄老年胆总管结石患者ERCP术中及术后的情况，评价丙泊酚联合静脉麻醉的安全性。
