Application of dexmedetomidine in different doses in combined with propofol in the painless colonoscopy in the elder patients

摘要

Objective:To explore the anesthetic effect of dexmedetomidine (Dex) in different doses in combined with propofol on the painless colonoscopy in the elder patients.Methods: A total of 60 elder patients who were admitted in our hospital from November 2016 to October 2017 for selective painless fiber colonoscopy were included in the study and divided into the low dose group and high dose group according to Dex dose. The micro-infusion pump was used to inject Dex 10 min before examination. The load capacity in the low dose group was 0.25 μg/kg, while in the high dose group was 0.75 μg/kg. The pump injection was completed within 10 min, then a continuous pump injection was performed in a speed of 0.5 μg/kg/h until the check off. After the completion of Dex pumping, propofol (1-1.5 mg/kg) was slowly injected. MAP, HR, and SpO2 before medication (T0), 5 min after inserting the endoscope (T1), and the time after the examination being finished (T2) were recorded, respectively. The bioelectrical impedance technique was used to continuously monitor SV, CO, and SVR. The awakening time, propofol dose, and discharge time were recorded.Results: The comparison of MAP, HR, and SpO2 at T0 between the two groups was not statistically significant. MAP, HR, SV, CO, and SVR at T1 and T2 were significantly lower than those at T0, while the comparison of SpO2 was not significantly changed. MAP at T1 in the high dose group was significantly higher than that in the low dose group, while HR at T1 and T2 was significantly lower than that in the low dose group. SV, CO, and SVR at T1 and T2 in the high dose group was significantly higher than those in the low dose group. The awakening time in the high dose group was significantly shorter than that in the low dose group, and the propofol dose was significantly less than that in the low dose group, while the comparison of discharge time was not significantly different. Conclusions: Application of Dex in a high dose in the painless colonoscopy in the elder patients can reduce the propofol dose, and will not increase the inhibiting effect on respiration and circulation.