Application of Painless Technique for Colonoscopy in Elderly Patients

Objective To investigate the efficacy and safety of monitored anesthesia care(MAC)by propofol combined with fentanyl in colonoscopy test in the elderly patients.Methods A total of 90 patients aged 60 years or older(ASA Ⅱ-Ⅲ) attending for colonoscopy were selected and randomly divided into three groups.GroupⅠwas firstly given fentanyl(0.5 μg/kg),and then propofol(1 mg/kg)intravenously two minutes later.Group Ⅱ was firstly given fentanyl(1 μg/kg),and two minutes later with propofol(1 mg/kg,intravenously).Group Ⅲ was firstly given saline(0.1 mL/kg),and two minutes later propofol(1 mg/kg,intravenously).The speed of propofol transfusion was controlled to 1 200 mL/h.If the colonoscopy was performed once the patients reached loss of eyelash reflex.If necessary,additional propofol,and stopped transfusion when reached to ileocecus.Analgesic efficacy rating was applied to the three groups of patients,including the observation before injection(T0),before inserting the colonoscopy(T1),splenic flexure(T2),during the liver piece(T3)and ileocecus for 5 minutes(T4) of HR,MAP,SpO2 changes;as well as the onset time,recovery time,the dosage of propofol anesthesia,hospitalization time and after the occurrence of adverse reactions.There was no apparent change in groupⅠ.However,in group Ⅱ and Ⅲ,HR,MAP was significantly lower compared with group I(P 0.05).Between group I and Ⅲ no significant difference was noted in onset,recovery and hospitalization time(P 0.05),but the dosage of propofol in group Ⅲ was higher than that in groupⅠ and Ⅱ.No nausea or vomiting was observed in three groups.Conclusion Propofol combined with 0.5 μg/kg fentanyl can be safely used in painless colonoscopy test in the elderly.