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| Effect of intravenous anesthesia with different doses of Nalbuphine combined with Propofol on elderly painless gastroscopy and its effects on neurocognitive disorders |
| CHAI Tianbo1 YANG Chuan1 ZHAO Zeyu2 GUO Jinjin1 WU Tianzhen1 YANG Lirong1 ZOU Zhenglian1 |
1.Department of Anesthesiology, the People′s Hospital of Chaotian District In Guangyuan, Sichuan Province, Guangyuan 628012, China;
2.Department of Anesthesiology, Affiliated Sichuan Bayi Rehabilitation Center of Chengdu University of Traditional Chinese Medicine, Sichuan Province, Chengdu 611135, China |
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Abstract Objective To compare the effects of different doses of Nalbuphine combined with Propofol on the elderly painless gastroscopy and its effects on neurocognitive disorders. Methods From March to December 2019, a total of 150 elderly patients who in the People′s Hospital of Chaotian District In Guangyuan, Sichuan Province, planned to undergo gastroscopy were randomly divided into N1, N2 and N3 groups by envelope method, with 50 patients in each group. Nalbuphine 0.06, 0.08 and 0.10 mg/kg were intravenous injected, Propofol was injected two minutes later and gastroscopy was performed. Systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR), respiratory rate (RR), and pulse oxygen saturation (SpO2) were recorded before Nalbuphine injection (T0), before Propofol injection (T1), before gastroscopy placement (T2), gastroscopy reaching the duodenum (T3), at the end of examination (T4) and after awakening (T5). Onset time of anesthesia, gastroscope time, time of waking and leaving hospital, Propofol dosage, and incidence of complications were recorded. The montreal cognitive assessment scale (MoCA) was used to evaluate the neurocognitive function at the time of discharge (T6), postoperative 24 h (T7) and postoperative 72 h (T8). Results SBP, DBP and HR of the three groups were compared at different time points and the differences were statistically significant (all P ＜ 0.05), while the intergroup comparison and interaction among the three groups were not statistically significant (all P ＞ 0.05). Compared with T0 and T1, SBP, DBP and HR in the three groups were all decreased in T2 to T4. There were no statistically significant differences in RR and SpO2 at time points, intergroup comparison and interaction among the three groups (all P ＞ 0.05). Compared with N1 group, the time of waking and leaving hospital in N2 and N3 groups were shorter and Propofol consumption were reduced, with statistically significant differences (P ＜ 0.05 or P ＜ 0.01). The time of waking and leaving hospital in N3 group was longer than that in N2 group, and the difference was statistically significant (P ＜ 0.05). There were no significant differences in the other indexes (all P ＞ 0.05). SpO2 < 90% and postoperative pain incidence in N2 and N3 groups were lower than N1 group, and the differences were highly statistically significant (all P ＜ 0.01), while the differences in the incidence of other indicators were not statistically significant (all P ＞ 0.05). MoCA score time points and intergroup comparison among the three groups showed statistically significant differences (all P ＜ 0.05), while the interaction difference was not statistically significant (P ＞ 0.05). Intra-group comparison: there were statistically significant differences among the three groups at each time point (all P ＜ 0.05). Comparison between groups: the MoCA score of N2 and N3 groups increased at T6 and T7 compared with N1 group, and the differences were statistically significant (all P ＜ 0.05); the MoCA score of N2 and N3 groups showed no statistically significant difference at T6 to T8 (P ＞ 0.05). Conclusion Nalbuphine 0.08 mg/kg combined with Propofol can shorten the recovery time, waking the dosage of Propofol and reduce the occurrence of neurocognitive disorders in the elderly patients during the anesthesia of painless gastroscopy.
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