Application of conscious sedation and analgesia with sufentanil combined with etomidate emulsion for painless gastroscopy

Abstract

Objective To explore the effectiveness,safety and feasibility of conscious sedation and analgesia with sufentanil combined with etomidate for painless gastroscopy.Methods 150 ASA grade 1 to 2 patients scheduled for painless gastroscopy were randomly divided into three groups:propofol group (group P),etomidate group (group E),and sufentanil combined etomidate group (group SE),50 for each group.Group P received propofol of 1.0-2.0 mg/kg,group E received etomidate of 0.1-0.2 ng/kg,and group DE receievd propofol of 0.1mg/kg and etomidate of 0.1 μ g/kg.All the intravenous injections were completed at a constant speed of 60 seconds.Additional intravenous injections of propofol 0.25-0.5 mg/kg or etomidate 0.025-0.05 mg/kg were administered based on body movements on examination in the patients.Preoperative and intraoperative average artery pressure (MAP),heart rate (HR),and percutaneous oxygen saturation (SPO2)were observed and noted.Time to orientation recovery and quality of recovery,and adverse reactions including myoclonus,bradycardia,and hypotension were noted.Results MAP,HR,and SPO2 at different time points did not differ significantly among the three groups (P＞0.05).MAP,HR,and SPO2 decreased significantly group P at T1 and T2,as compared with the baselines; hemodynamics was more stable in groups E and SE than in group P.The quality of consciousness recovery was significantly better in groups SE and P than in group E based on orientation recovery time and OAA/S scores,postoperative somnolence was significantly less (P＜0.05),and recovery time was shorter higher,but with no significant statistical differences (P＞0.05).4 patients in group E occurred myoclonus whereas no more than 2 patients developed myoclonus in group P or SE,with a statistical significance (P＜0.05).Conclusions Conscious sedation and analgesia with sufentanil plus etomidate for painless gastroscopy achieves a satisfactory anesthetic effect and has fewer adverse reactions.It is a safe,effective,reliable approach for anesthesia Key words: Sufentanil; Etomidate; Conscious sedation and analgesia; Painless gastroscopy