Randomized Controlled Trial
Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Oct 26, 2019; 7(20): 3237-3246
Published online Oct 26, 2019. doi: 10.12998/wjcc.v7.i20.3237
Combination of propofol and dezocine to improve safety and efficacy of anesthesia for gastroscopy and colonoscopy in adults: A randomized, double-blind, controlled trial
Xue-Ting Li, Chao-Qun Ma, Si-Hua Qi, Li-Min Zhang
Xue-Ting Li, Si-Hua Qi, Li-Min Zhang, Department of Anaesthesiology, The Fourth Affiliated Hospital, Harbin Medical University, Harbin 150001, Heilongjiang Province, China
Chao-Qun Ma, Department of Neurosurgery, Harbin 242 Hospital, Harbin 150066, Heilongjiang Province, China
Author contributions: Li XT, Ma CQ, Qi SH, and Zhang LM designed the research; Li XT, Qi SH, and Zhang LM performed the research; Ma CQ and Zhang LM analyzed the data; and Zhang LM wrote the paper.
Institutional review board statement: The study was reviewed and approved by The Fourth Affiliated Hospital of Harbin Medical University Institutional Review Board.
Clinical trial registration statement: This study is registered at the Chinese Clinical Trial Register (http://www.chictr.org.cn). The registration identification number is No. ChiCTR1800017630.
Informed consent statement: All study participants, or their legal guardian, provided written informed consent prior to study enrollment.
Conflict-of-interest statement: The authors have no conflicts of interest to declare.
Data sharing statement: No additional data are available.
CONSORT 2010 statement: The authors have read the CONSORT 2010 Statement, and the manuscript was prepared and revised according to the CONSORT 2010 Statement.
Open-Access: This is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Li-Min Zhang, MD, Adjunct Professor, Department of Anaesthesiology, The Fourth Affiliated Hospital, Harbin Medical University, 37 Yiyuan Street, Harbin 150001, Heilongjiang Province, China. university0501@163.com
Telephone: +86-451-82576626
Received: June 17, 2019
Peer-review started: June 17, 2019
First decision: August 3, 2019
Revised: September 3, 2019
Accepted: September 9, 2019
Article in press: September 9, 2019
Published online: October 26, 2019
Processing time: 131 Days and 13.2 Hours
Abstract
BACKGROUND

Gastroscopy and colonoscopy are important and common endoscopic methods for the diagnosis and treatment of gastrointestinal and colorectal diseases. However, endoscopy is usually associated with adverse reactions such as nervousness, nausea, vomiting, choking cough, and pain. Severe discomfort, such as vomiting, coughing, or body movement, may lead to aggravation of a pre-existing condition or even interruption of examination or treatment, especially in some critically ill patients with physiological dysfunction (e.g., cardiovascular or respiratory disease). The optimal methods for inducing analgesia and sedation in endoscopy are areas of ongoing debate; nevertheless, determining an appropriate regimen of sedation and analgesia is important.

AIM

To evaluate the effects of propofol combined with dezocine, sufentanil, or fentanyl in painless gastroscopy and colonoscopy.

METHODS

Four hundred patients were randomly assigned to one of four groups for anesthesia: intravenous dezocine, sufentanil, fentanyl, or saline. Propofol was administered intravenously for induction and maintenance of anesthesia.

RESULTS

The dosage of propofol in the dezocine group was significantly lower than those in other groups (P < 0.01). Bispectral index and Steward score (0-6 points, an unresponsive, immobile patient whose airway requires maintenance to a fully recovered patient) after eye opening in the dezocine group were significantly higher than those in other groups (P < 0.01). Awakening time and postoperative pain score (0-10 points, no pain to unbearable pain) in the dezocine group were significantly lower than those in other groups (P < 0.01). Mean arterial pressure and pulse oxygen saturation in the dezocine group were significantly more stable at various time points (before dosing, disappearance of eyelash reflex, and wakeup) than those in other groups (P < 0.01). The rates of hypopnea, jaw thrust, body movements, and usage of vasoactive drugs in the dezocine group were significantly lower than those in other groups (P < 0.01). Additionally, the rates of reflex coughing, nausea, and vomiting were not statistically different between the four groups (P > 0.05).

CONCLUSION

The combination of propofol and dezocine can decrease propofol dosage, reduce the risk for the development of inhibitory effects on the respiratory and cardiovascular systems, increase analgesic effect, decrease body movement, shorten awakening time, and improve awakening quality.

Keywords: Anesthesia; Dezocine; Propofol; Gastroscopy; Colonoscopy

Core tip: This study aimed to identify a comparatively satisfactory anesthetization regimen for painless gastroscopy and colonoscopy. The combination of propofol and dezocine can decrease propofol dosage, reduce the risk for the development of inhibitory effects on the cardiovascular and respiratory systems, increase analgesic effect, decrease body movement, shorten awakening time, and improve awakening quality. Anesthesia with propofol combined with dezocine is an adequate regimen of anesthesia and analgesia for gastroscopy and colonoscopy, which can increase the patient cooperation, quality and safety of the examination and treatment, and patient and physician satisfaction with anesthesia.