Anesthesia of oxycodone hydrochloride and propofol combination by target-controlled infusion in patients with choledocholithiasis undergoing ERCP treatment
Objective The aim of this study was to investigate anesthesia of oxycodone hydrochloride and propofol combination by target-controlled infusion in patients with choledocholithiasis undergoing endoscopic retrograde cholangiopancreatography(ERCP)treatment.Methods In this clinical trial,we enrolled 75 patients with imaging-confirmed choledocholithiasis between June 2021 and June 2023,and all underwent ERCP for removal of common bile duct stones.We randomly assigned patients to receive target-controlled infusion of propofol and remifentanil(control,n=37)or intravenous infusion of oxycodone hydrochloride before target-controlled infusion of propofol for anesthesia induction and maintenance.The mean arterial pressure(MAP),heart rate(HR)and anesthesia depth(BIS)were routinely monitored before induction(T0),5 min after induction(T1),at the time of endoscopy to duodenal papilla(T2)and at the end of surgery(T3).Serum cortisol(Cor)levels was detected by radioimmunoassay,serum norepinephrine(NE)level was measured by ELISA,and serum glucose(Glu)level was detected by hexokinase method.Ramsay score was used to evaluate the sedation status,and visual analogue scale(VAS)was adopted to evaluate the analgesia effect.Results By T2,MAP in the observation decreased by 2.8％(95％CI:-5.0％-0.1％,P＜0.05),HR decreased by 4.3％(95％CI:-6.6％-0.1％,P＜0.05),and BIS decreased by 2.1％(95％CI:-2.4％-0.2％,P＜0.05)as compared to in the control;serum Cor level decreased by-11.7％(95％CI:-13.6％-1.1％,P＜0.05),serum NE level decreased by 10.3％(95％CI:-15.4％-0.04％,P＜0.05),and blood Glu level decreased by 11.9％(95％CI:-16.2％-1.7％,P＜0.05)compared to those in the control;by 30 minutes after waking-up(N1)and 2 hours after waking-up(N2),the VAS scores in the observation decreased by 14.3％(95％CI:-16.0％-1.6％,P＜0.05)and 16.0％(95％CI:-18.1％-1.9％,P＜0.05)as compared to those in the control;the dosage of propofol used in the observation decreased by 9.6％(95％CI:-14.7％-3.1％,P＜0.05)compared to that in the control.Conclusion The intravenous administration of oxycodone hydrochloride and target-controlled infusion of propofol for anesthesia in patients with choledocholithiasis undergoing ERCP has clinically meaningful anesthesia,with relatively small effect on intraoperative hemodynamics and less body stress reaction.
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