Effects of different doses of propofol target-controlled infusion anesthesia on hemodynamics,analgesia,and safety in patients with common ble duct stones undergoing endoscopic retrograde cholangiopancre-atography combined with endoscopic sphincterotomy
Objective To investigate the clinical observation of different doses of propofol target con-trolled infusion anesthesia in the treatment of choledocholithiasis by ERCP combined with endoscopic sphinctero-tomy.Methods A total of 300 patients with choledocholithiasis undergoing ERCP combined with endoscopic sphincterotomy at Lishui People's Hospital from December 2019 to January 2023 were selected and divided into low-dose propofol(LP)group,medium-dose propofol(MP)group,and high-dose propofol(HP)group,with 100 cas-es in each group.The LP group,MP group,and HP group were all administered propofol target controlled infusion at doses of 1,3,and 5 μg/ml,respectively.The clinically relevant indicators of the three groups were observed and analyzed.Results The MAP of LP group at T0,T1,T2,T3,T4 and T5 were(88±6)mmHg,(77±5)mmHg,(71±5)mmHg,(70±5)mmHg,(75±5)mmHg and(84±7)mmHg,respectively;The MP group was(87±6)mmHg,(78±5)mmHg,(70±5)mmHg,(70±5)mmHg,(76±6)mmHg,(83±6)mmHg,respectively.The HP group was(88±6)mmHg,(77±5)mmHg,(71±5)mmHg,(71±5)mmHg,(75±5)mmHg,(83±6)mmHg,respectively.The HR of LP group at T0,T1,T2,T3,T4 and T5 were(78±6)beats per minute,(73±5)beats per minute,(67±5)beats per minute,(68±5)beats per minute,(71±6)beats per minute and(80±6)beats per minute,respectively;MP group was(78±6)beats per minute,(72±5)beats per minute,(68±5)beats per minute,(67±5)beats per minute,(71±6)beats per minute,(80±6)beats per minute,respectively.They were(78±6)beats per minute,(73±5)beats per minute,(67±5)beats per minute,(67±5)beats per minute,(72±6)beats per minute,(79±6)beats per minute,respectively.At T0,there were no significant differences in MAP,HR levels and VAS scores among the three groups(P＞0.05);at T1 and T2,MAP and HR levels of the three groups were significantly decreased(P＜0.05),but there were no signifi-cant differences in MAP and HR levels among the three groups(P＞0.05).There was no significant difference in the comparison of MAP and HR levels among the three groups at T2 and T3(P＞0.05),while at T4 and T5,the MAP and HR levels were significantly increased,but there was no significant difference in the comparison of MAP and HR levels among the three groups(P＞0.05),and there was no interaction between groups and time(F=0.249,P=0.991).The VAS scores of LP group at T0,T1,T2,T3,T4 and T5 were(4.25±0.22)points,(2.34±0.15)points,(2.41±0.16)points,(2.38±0.14)points,(4.33±0.23)points and(5.21±0.26)points,respectively.In MP group,the results were(4.35±0.24),(1.85±0.14),(1.82±0.13),(1.84±0.12),(3.65±0.14)and(4.78±0.21),respectively.In HP group,they were(4.30±0.23)points,(1.36±0.11)points,(1.33±0.11)points,(1.37±0.12)points,(2.96±0.13)points and(3.55±0.18)points.VAS scores in T1,T2 and T3 groups were significantly decreased(P＜0.05),and compared with LP group,the MP group was significantly decreased(P＜0.05),compared with MP group,the HP group was significantly decreased(P＜0.05),and the VAS scores in T4 and T5 groups were increased,and the LP group was significantly increased than MP and HP groups(P＜0.05).There is an interaction between groups and time group(P＜0.001).Compared with LP group,there were no significant differences in operation time,intraoperative blood loss and hospital stay in MP group(P＞0.05),while there were no significant differences in operation time,intraop-erative blood loss and hospital stay in HP group(P＞0.05).Compared with LP group,there were no significant dif-ferences in respiratory recovery time,wake time and extubation time in MP group(P＞0.05).There were no signifi-cant differences in respiratory recovery time,wake time and extubation time in HP group(P＞0.05).The adverse reactions of nausea,vomiting,respiratory depression,hypertension,bradycardia and delirium in LP group,MP group and HP group were 21.0％,25.0％and 30.0％,respectively,and there were no significant differences a-mong groups(x2=2.150,P＞0.05).Conclusions Low,medium and high doses of propofol can neither change hemodynamics nor prolong the recovery time,and high doses of propofol have better analgesic effect,suggesting that propofol target controlled infusion anesthesia has a satisfactory effect and high safety in the treatment of com-mon choledocholithiasis with ERCP combined with endoscopic sphincterotomy.
万方数据
维普
