Zhang Ying-Yan
Department of Anesthesiology, People's Hospital of Wuhan Economic and Technological Development Zone (Hannan District), Wuhan 430090, Hubei Province, China.
World J Gastrointest Surg. 2025 Jul 27;17(7):106901. doi: 10.4240/wjgs.v17.i7.106901.
Elderly patients often display age-related physiological decline, which increases their susceptibility to complications during medical procedures. Therefore, it is clinically imperative to refine anesthetic protocols for painless gastroscopy in this vulnerable population.
To explore the effects of the etomidate-propofol combination on anesthesia quality, compliance, and adverse reactions in elderly patients undergoing painless gastrointestinal endoscopy.
A total of 103 elderly patients scheduled for painless gastrointestinal endoscopy at the Hospital of Wuhan Economic and Technological Development Zone (Hannan District) between October 2022 and October 2024 were enrolled. The participants were divided into a control group ( = 50) receiving propofol anesthesia and an observation group ( = 53) that received a combination of etomidate and propofol anesthesia. The anesthesia quality (including induction time, recovery time, and orientation recovery time), compliance, hemodynamic parameters (heart rate, oxygen saturation, systolic/diastolic blood pressure), adverse reactions (muscle tremors, injection pain, respiratory depression, hypotension, and nausea/vomiting), and analgesic and sedative effects [evaluated using the visual analog scale (VAS) and Ramsay score] were comparatively analyzed.
The observation group had significantly shorter anesthesia induction, recovery, and orientation recovery times than the control group. Moreover, the observation group showed higher compliance; greater hemodynamic stability at preanesthesia (T0), during anesthesia (T1), and postrecovery (T2) time points; and a significantly lower incidence of adverse reactions. The VAS and Ramsay scores at 5, 30, and 60 minutes after anesthesia recovery were also significantly lower in the observation group than in the control group.
The etomidate-propofol combination for painless gastrointestinal endoscopy in elderly patients may provide superior anesthesia quality and improved compliance and safety, making it a promising approach for clinical application.
老年患者常出现与年龄相关的生理机能衰退，这增加了他们在医疗过程中发生并发症的易感性。因此，针对这一脆弱人群优化无痛胃镜麻醉方案在临床上势在必行。
探讨依托咪酯 - 丙泊酚联合用药对老年患者无痛胃肠镜检查麻醉质量、依从性及不良反应的影响。
选取2022年10月至2024年10月在武汉经济技术开发区（汉南区）医院计划进行无痛胃肠镜检查的103例老年患者。将参与者分为接受丙泊酚麻醉的对照组（n = 50）和接受依托咪酯与丙泊酚联合麻醉的观察组（n = 53）。对麻醉质量（包括诱导时间、苏醒时间和定向恢复时间）、依从性、血流动力学参数（心率、血氧饱和度、收缩压/舒张压）、不良反应（肌肉震颤、注射痛、呼吸抑制、低血压和恶心/呕吐）以及镇痛和镇静效果[使用视觉模拟量表（VAS）和Ramsay评分进行评估]进行比较分析。
观察组的麻醉诱导、苏醒和定向恢复时间明显短于对照组。此外，观察组表现出更高的依从性；在麻醉前（T0）、麻醉期间（T1）和苏醒后（T2）时间点血流动力学稳定性更高；不良反应发生率显著更低。麻醉恢复后5、30和60分钟时，观察组的VAS和Ramsay评分也明显低于对照组。
依托咪酯 - 丙泊酚联合用于老年患者无痛胃肠镜检查可能提供更优的麻醉质量、更好的依从性和安全性，使其成为一种有前景的临床应用方法。
