Efficacy observation of different doses of fentanyl on painless gastroscopy in elderly patients with cardiac dysfunction

Objective To observe the effects and security of painless gastroscopy after nesthesia with different fentanyl doses combined with propofol used in elderly patients with cardiac dysfunction. Methods 60 patients with cardiac dysfunction( Ⅱ level and above) whom were taken digestive endoscopy were randomly divided into three groups:pure propofol group(group P,n=20),1 μg/kg fentanyl combined with propofol group(group F1,n=20),2 μg/kg fentanyl combined with propofol group(group F2,n=20).Intraoperative blood pressure(NBP),heart rate(HR),pulse oximetry(SpO2),propofol dosage,intraoperative body movement,postoperative recovery time and recovery time orientation,hypotension,breathing inhibition,the incidence and complications of nausea and vomiting were observed and recorded. Results The propofol dosage of group P was significantly greater than that of group F1and F2(P0.05);the body movement cases of group F2were significantly less than that of group F1and group P(P0.05);the awakening time of group P after checking was longest,followed by group F1,group F2,the difference were all statistically significant(P0.05);the differences of orientation recovery time in the three groups was not statistically significant( P0.05);MAP and HR of group P,F1after induction decreased significantly larger than that of group F2(P0.05),but the difference of group F1and group P was not statistically significant(P0.05).There were 4,2,1 cases with respiratory depression in group P,group F1and group F2,and they were recover soon after oxygen masks(P0.05).Three was no severe nausea and vomiting or other adverse reactions found in the groups. Conclusion With the doses of 2 μg/kg fentanyl on painless gastroscopy in cardiac insufficiency patients can significantly reduce the propofol dosage,keeps vital signs stable,and don ′t affect the recovery of awakening and orientation,it is safe and reliable.