Objective To evaluate the intravenous anesthesia effect and safety of Oxycodone with Propofol target-controlled infusion (TCI) on endoscopic retrograde cholangiopancreatography (ERCP). Methods Totally 75 elderly cases receiving ERCP (ASAⅠ-Ⅲ) were randomly divided into 3 groups (25 in each group):Propofol group (group P), Fentanyl+Propofol group (group FP) and Oxycodone+Propofol group (group OP). In the group P, TCI of Propofol was adopted, effect site concentration (Ce) was started from 1.0μg/ml for anesthesia induction, then adjusted according to the bispectral index (BIS) value, and ERCP began when the BIS value reduced to 40. In the groups FP and OP, slowly intravenous injection started with Fentanyl (1.0μg/kg) and Oxycodone (0.1 mg/kg) respectively 5 min before the induction and was followed by TCI of Propofol, and ERCP began after BIS reduced to 40. The plasma target concen-tration of propofol was adjusted during operation according to BIS value (maintained between 40 and 60). SBP, DBP, HR and TCI concentration were recorded before induction (T0), 5 min after induction (T1), when the lens was into the duodenal papilla (T2), during operation (T3) and when the patients recovered consciousness (T4). Meanwhile, the adverse reactions and gastric convulsion ache were observed. Results Compared with the group P, SBP, DBP and HR at T1-4 in the groups FP and OP were more stable ( < 0.05); TCI concentration of Propofol at T1-3 significantly lowered in the groups FP and OP ( < 0.01); the intraoperative body movement, the postoperative gastric convulsion ache and the total Propofol dosage were obviously reduced ( < 0.05), the awaking time was shortened ( < 0.05), and the adverse reactions were fewer ( <0.05) in the groups FP and OP. Compared with the group FP, the adverse reactions were much fewer in the group OP ( <0.05 or 0.01). Conclusions Combined anesthesia with Oxycodone and Propofol for ERCP can maintain smooth respiratory cycle, obviously lower the dosage of Propofol, strengthen the effect of intra-operative analgesia, significantly reduce intraoperative body movement and the occurrence of postoperative gastric spasm pain with few adverse reactions. It is suitable for clinical promotion.%目的：观察盐酸羟考酮复合丙泊酚靶控输注麻醉实施内窥镜逆行胰胆管造影术（ERCP）诊疗术，评价其麻醉效果及安全性，为ERCP术提供新的麻醉药物组合。方法75例自愿接受无痛ERCP的老年患者， ASAⅠ～Ⅲ级，随机均分成3组，单纯丙泊酚组（P组）、芬太尼+丙泊酚组（FP组）和羟考酮+丙泊酚组（OP组）。P组靶控输注（TCI）丙泊酚，效应室浓度（Ce）从1.0μg/ml开始作麻醉诱导，根据脑电双频指数（BIS）值，调整丙泊酚的输注浓度，待BIS值降至40后开始ERCP操作；FP组和OP组分别于诱导前5 min缓慢静注芬太尼1.0μg/kg和盐酸羟考酮0.1 mg/kg后，实施TCI丙泊酚，待BIS值降至40后开始ERCP操作。术中根据BIS值（维持40～60之间）调整丙泊酚血浆靶浓度。记录3组诱导前（T0）、诱导后5 min（T1）、进镜至十二指肠乳头时（T2）、术中（T3）、清醒（T4）的SBP、DBP、HR及TCI浓度；观察术中体动情况和术后胃痉挛痛分级；同时记录3组患者丙泊酚的总用量、麻醉恢复时间，丙泊酚注射痛、呛咳、恶心呕吐、咽部不适、低血压及低氧血症等并发症的发生率。结果与P组比较，在T1~4时间点FP组和OP组患者SBP、DBP和HR变化更平稳（<0.05）， T1~3时间点FP组和OP组丙泊酚TCI浓度明显降低（<0.01），FP组和OP组患者术中体动和术后胃痉挛痛明显减轻（<0.05或0.01）、丙泊酚总用量和苏醒时间明显减少（<0.05或0.01）、丙泊酚注射痛、咽部不适、低血压等不良反应发生率明显降低（<0.01）；与FP组比较，OP组患者呛咳反应和恶心呕吐发生率明显减少（<0.05或0.01）。结论盐酸羟考酮复合丙泊酚靶控输注用于老年ERCP术麻醉，呼吸循环平稳，可明显减少丙泊酚用量，加强术中镇痛效果，明显减轻术中体动和术后胃痉挛痛发生，不良反应低，适合临床推广。
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