Application of short-term conscious analgesia and sedation with Remifentanil and Propofol in elderly outpatients with esophageal foreign body

doi:10.3877/cma.j.issn.1674-0785.2020.12.002

Abstract

Abstract:

Objective

To explore the clinical application of short-term conscious analgesia and sedation with Remifentanil and Propofol in elderly outpatients with esophageal foreign body.

Methods

Sixty elderly outpatients who were treated for esophageal foreign body at the Endoscopy Center of Northern Jiangsu People's Hospital from September 2018 to September 2019 were selected. Those patients were randomly divided into either a control group or a conscious analgesia and sedation group (CA group) with 30 cases each using a random number table. The control group underwent analgesia with Propofol alone, while the CA group underwent short-term conscious analgesia and sedation. Comparison was made between the two groups in terms of Ramsay sedation score standard time, intraoperative hypotension and hypoxia, additional times of anesthesia, post-anesthesia resuscitation time, telephone follow-up at postoperative 24 h to assess the occurrence of uncomfortable symptoms like nausea and vomiting, patient satisfaction, and endoscopic surgeon satisfaction.

Results

The mean time to predetermined Ramsay score in the CA group was significantly longer than that of the control group [(50.73±6.78) s vs (24.47±7.00) s, t=14.765, P＜0.001]. The incidence of intraoperative hypotension in the CA group (20.0%, 6/30) was significantly lower than that of the control group (66.7%, 20/30) (χ²=13.303, P＜0.001). Post-anesthesia resuscitation time in the CA group was significantly shorter than that of the control group [(5.63±2.61) min vs (22.63±3.73) min, t=20.472, P＜0.001]. The occurrence of postoperative discomfort symptoms in the CA group (6.7%,2/30) was significantly lower than that of the control group (26.7%,8/30) (χ²=4.32, P＜0.05). There were no significant differences in intraoperative hypoxemia, additional times of anesthesia, patient satisfaction, or endoscopic surgeon satisfaction between the two groups (P＞0.05).

Conclusion

Remifentanil combined with Propofol for short-term conscious analgesia and sedation can not only ensure intraoperative stability and rapid postoperative resuscitation, but also reduce postoperative uncomfortable symptoms, which is suitable for elderly outpatients with esophageal foreign body.

Key words: Esophageal foreign body, Outpatient, Elderly, Conscious analgesia, Conscious sedation

Xin Liu, Ju Gao, Ting Chen, Yingying Wu. Application of short-term conscious analgesia and sedation with Remifentanil and Propofol in elderly outpatients with esophageal foreign body[J]. Chinese Journal of Clinicians(Electronic Edition), 2020, 14(12): 962-966.

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https://zhlcyszz.cma-cmc.com.cn/EN/Y2020/V14/I12/962

Figures/Tables 2

组别	例数	性别[例（%）]		年龄（岁， $x ¯$ ±s）	BMI（kg/m² $x ¯$ ±s）
组别	例数	男	女	年龄（岁， $x ¯$ ±s）	BMI（kg/m² $x ¯$ ±s）
对照组	30	22（66.7）	8（33.3）	70.43±3.85	23.56±3.31
CA组	30	20（66.7）	10（33.3）	70.47±5.08	23.46±3.28
统计值		χ²=0.000		t=0.029	t=0.636
P值		1.000		0.977	0.578

组别	例数	性别[例（%）]		年龄（岁， $x ¯$ ±s）	BMI（kg/m² $x ¯$ ±s）
组别	例数	男	女	年龄（岁， $x ¯$ ±s）	BMI（kg/m² $x ¯$ ±s）
对照组	30	22（66.7）	8（33.3）	70.43±3.85	23.56±3.31
CA组	30	20（66.7）	10（33.3）	70.47±5.08	23.46±3.28
统计值		χ²=0.000		t=0.029	t=0.636
P值		1.000		0.977	0.578

组别	例数	Ramsay镇静评分达标时间（s， $x ¯$ ±s）	术中低血压发生情况[例（%）]		术中低血氧发生情况[例（%）]		麻醉药额外追加次数[例（%）]
组别	例数	Ramsay镇静评分达标时间（s， $x ¯$ ±s）	无	有	无	有	0次	1次	2次
对照组	30	24.47±7.00	10（33.3）	20（66.7）	24（80.0）	6（2.0）	20（66.7）	7（23.3）	3（10.0）
CA组	30	50.73±6.78	24（80.0）	6（20.0）	25（83.3）	5（16.7）	20（66.7）	8（26.7）	2（ 6.7）
统计值		t=14.765	χ²=13.303		χ²=0.111		χ²=0.089
P值		＜0.001	＜0.001		0.739		0.929
组别	例数	麻醉恢复时间（min， $x ¯$ ±s）	术后不适症状发生情况[例（%）]		患者满意度（分， $x ¯$ ±s）		内镜操作医生满意度（分， $x ¯$ ±s）
组别	例数	麻醉恢复时间（min， $x ¯$ ±s）	无	有	患者满意度（分， $x ¯$ ±s）		内镜操作医生满意度（分， $x ¯$ ±s）
对照组	30	22.63±3.73	22（73.3）	8（26.7）	96.33±3.70		97.90±2.53
CA组	30	5.63±2.61	28（93.3）	2（6.7）	96.83±3.08		98.07±2.54
统计值		t=20.472	χ²=4.320		t=0.569		t=0.332
P值		＜0.001	0.038		0.571		0.741

组别	例数	Ramsay镇静评分达标时间（s， $x ¯$ ±s）	术中低血压发生情况[例（%）]		术中低血氧发生情况[例（%）]		麻醉药额外追加次数[例（%）]
组别	例数	Ramsay镇静评分达标时间（s， $x ¯$ ±s）	无	有	无	有	0次	1次	2次
对照组	30	24.47±7.00	10（33.3）	20（66.7）	24（80.0）	6（2.0）	20（66.7）	7（23.3）	3（10.0）
CA组	30	50.73±6.78	24（80.0）	6（20.0）	25（83.3）	5（16.7）	20（66.7）	8（26.7）	2（ 6.7）
统计值		t=14.765	χ²=13.303		χ²=0.111		χ²=0.089
P值		＜0.001	＜0.001		0.739		0.929
组别	例数	麻醉恢复时间（min， $x ¯$ ±s）	术后不适症状发生情况[例（%）]		患者满意度（分， $x ¯$ ±s）		内镜操作医生满意度（分， $x ¯$ ±s）
组别	例数	麻醉恢复时间（min， $x ¯$ ±s）	无	有	患者满意度（分， $x ¯$ ±s）		内镜操作医生满意度（分， $x ¯$ ±s）
对照组	30	22.63±3.73	22（73.3）	8（26.7）	96.33±3.70		97.90±2.53
CA组	30	5.63±2.61	28（93.3）	2（6.7）	96.83±3.08		98.07±2.54
统计值		t=20.472	χ²=4.320		t=0.569		t=0.332
P值		＜0.001	0.038		0.571		0.741

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