A feasibility study of continuous remifentanil infusion alone for conscious sedation during ERCP for elderly patients
SUO Libin1,LIU Kunpeng2,LI Chenghui2,ZHANG Jinhua2,LI Shaowei3,LI Zhao2,LU Cheng2,and LI Weixia2.
1.Department of Anesthesiology, 2.Department of General Surgery, Beijing Municipal Corps Hospital,Chinese People’s Armed Police Forces,Beijing 100027, China; 3.Department of Anesthesiology,China-Japan Friendship Hospital,Beijing 100029;China
Abstract：Objective To study the clinical efficacy and safety of remifentanil infusion alone for conscious sedation during ERCP for elderly patients. Methods Eighty-nine patients, ASA physical status Ⅰ-Ⅲ,aged 70-89 years,scheduled for ERCP were infused remifentanyl continuously at a rate of 0.2 μg/(kg·min) for 5 min before operation,and decreased to 0.15 μg/(kg·min) after operation; other drugs were not given. Blood pressure,heart rate,respiratory rate, oxygen saturation,bispectral index during operation were recorded before anesthetic induction(T0),at beginning of operation(T1),5 min after operation(T2),10 min after operation(T3)and at end of operation(T4).The Modified Aldrete scores,operator satisfaction scores and side effects were observed after operation,operation time and anesthesia time were also recorded. Results Compared with preinduction values,blood pressures at T2 were significantly high,heart rates at T1,T2,T3 and T4 were significantly high, SpO2 values at T4 were significantly low,BIS at T1,T2,T3 and T4 were significantly low. Uncontrolled agitation and movement during sedation did no occurr in both groups. Oxggensaturation of <90% was observed in 5 patients, no intubation and face mask ventilation were required. During insertion of duodenoscopy,nausea occurred in 5 patients,5 patients felt slight pain during stone extraction action. Eight patients were forgot the insertion of duodenoscope and stone extraction,19 patients remembered the insertion of duodenoscope,62 patients remembered both actions above. 9 patients were asleep at the end of operation,the other patients were awaken.The operator satisfaction scores were 97.1±2.8. Conclusions The continuous remifentanil infusion alone for conscious sedation during ERCP for elderly patients shows satisfactory anesthesia effect and safety.
索利斌,刘鲲鹏,李成辉,张金华,李少伟,李昭,陆承,李卫霞. 瑞芬太尼用于高龄患者内镜逆行胰管造影术的镇静效果和安全性[J]. , 2013, 24(11): 929-932.
SUO Libin,LIU Kunpeng,LI Chenghui,ZHANG Jinhua,LI Shaowei,LI Zhao,LU Cheng,and LI Weixia.. A feasibility study of continuous remifentanil infusion alone for conscious sedation during ERCP for elderly patients. , 2013, 24(11): 929-932.
ASGE Standards of Practice Committee. Guidelines for the use of deep sedation and anesthesia for GI endoscopy [J]. Gastrointest Endosc,2002,56:613-617.
[1]
ASGE Standards of Practice Committee. Guidelines for the use of deep sedation and anesthesia for GI endoscopy [J]. Gastrointest Endosc,2002,56:613-617.
[2]
The American Society of Anesthesiologists. Practice guidelines for sedation and analgesia by non-anesthesiologists [J]. Anesthesiology, 2002,96:1004-1017.
[2]
The American Society of Anesthesiologists. Practice guidelines for sedation and analgesia by non-anesthesiologists [J]. Anesthesiology, 2002,96:1004-1017.
Raymondos K,Panning B,Bachem I,et al.Evaluation of endoscopic retrogradecholangiopancreatography under conscious sedation and general anesthesia[J].Endoscopy,2002,34:721-726.
[4]
Raymondos K,Panning B,Bachem I,et al.Evaluation of endoscopic retrogradecholangiopancreatography under conscious sedation and general anesthesia[J].Endoscopy,2002,34:721-726.
[5]
Akcaboy,Z N,Akcaboy E Y,Albayrak D,et al.Can remifentanil be a better choice than propofol for colonoscopy during monitored anesthesia care?[J].Acta anaesthesiol scand,2006,50:736-741.
[5]
Akcaboy,Z N,Akcaboy E Y,Albayrak D,et al.Can remifentanil be a better choice than propofol for colonoscopy during monitored anesthesia care?[J].Acta anaesthesiol scand,2006,50:736-741.
[6]
Laumers M,Camu F,Breivik H,et al.The safety and effectiveness of remifentanil as an adjunct sedative for regional anesthesia[J].Anesth Analg,1999,88:134-140.
[6]
Laumers M,Camu F,Breivik H,et al.The safety and effectiveness of remifentanil as an adjunct sedative for regional anesthesia[J].Anesth Analg,1999,88:134-140.
2013, Vol. 24 
