Clinical efficacy analysis of alfentanil combined with propofol sedation anesthesia in therapeutic ERCP
Objective To explore the clinical efficacy of alfentanil combined with propofol sedation anesthesia in therapeutic endoscopic retrograde cholangiopancreatography(ERCP).Methods A total of 200 patients admitted to the Department of Gastroenterology,the First Affiliated Hospital of Shihezi University from January 2022 to April 2023 who underwent therapeutic ERCP and were eligible for American Society of Anesthesiology gradeⅠ-Ⅱwere selected as the study subjects.They were divided into two groups,with 100 patients in each group,using a random number table method.Two groups were intramuscularly injected with 10 mg of diazepam,50 mg of pethidine,and 10 mg of anisodamine 30 minutes before surgery.The control group underwent surgery while the patient was conscious.The experimental group received slow intravenous injection of 25-75 mcg/kg of afentanil and 1.5-2 mg/kg of propofol to induce sedation before surgery.During the surgery,propofol and afentanil were continuously pumped intravenously.The hemodynamics(heart rate[HR],systolic blood pressure[SBP],diastolic blood pressure[DBP],blood oxygen saturation[SpO2])before and after surgery,the time required to complete the surgery,the sedation and analgesia effects(Ramsay score[1-6 points]was used for sedation,visual analogue scale[VAS]was used for analgesia[0-10 points]),the changes in cognitive function(mini mental state examination[MMSE]score)before and after surgery,and the incidence of adverse reactions were compared between two groups of patients.Results Before induction,there was no significant difference in HR,SBP,DBP and SpO2 between the two groups(P>0.05).When the surgery begin,the values of HR,SBP and DBP in the experimental group were lower than those in the control group,and the value of SpO2 was higher than that in the control group,with statistical significance(P<0.05).The time required to complete the surgery in the experimental group was significantly shorter than that in the control group,with statistical significance(P<0.05).The Ramsay score of the control group was significantly lower than that of the experimental group during surgery,and the VAS score of the control group was significantly higher than that of the experimental group after surgery,with statistical significance(P<0.05).There was no significant difference in MMSE scores between the two groups before anesthesia(P>0.05).Two hours after surgery,the MMSE scores of both groups decreased,but there was no significant difference in MMSE scores between the two groups(P>0.05).The total incidence of adverse reactions in the experimental group(8.00%)was significantly different from that in the control group(25.00%)(P<0.05).Conclusion Afentanil combined with propofol has a good clinical efficacy in the therapeutic ERCP,which can effectively maintain the stable hemodynamic level and significantly shorten the surgery time.The sedative and analgesic effect and safety are good,and the incidence of adverse reactions is low,which is worthy of further promotion and application in clinic.
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