Application of Propofol Mixed With Remifentanil in Fiber Colonoscopyand Analgesia in Fiber Colonoscopy
Condition: Narcotism
Study type: Interventional

Summary: 
      Fiber colonoscopy, as a terminal examination method for lower gastrointestinal diseases,
      often brings varying degrees of pain, discomfort, tension, and anxiety to patients.
      Therefore, currently in clinical practice, intravenous anesthesia is often chosen to reduce
      discomfort. At present, intravenous propofol and fentanyl are most widely used in clinical
      practice, but intravenous general anesthesia can lead to hemodynamic fluctuations and an
      increase in anesthesia related complications such as prolonged hospital stay after surgery.
      Propofol and remifentanil have the characteristics of fast onset, short duration of action,
      and rapid awakening. The purpose of this study is to observe the efficacy and adverse
      reactions of remifentanil combined with low-dose propofol in patient-controlled analgesia and
      sedation during colonoscopy, in order to explore the safety and effectiveness of this method.
    

Detailed description: 
      Fibercolonoscopy, as a terminal examination method for lower digestive tract diseases, often
      brings different degrees of pain and discomfort, tension and anxiety to patients. Therefore,
      at present, intravenous anesthesia is often used in clinical practice to reduce discomfort,
      and intravenous propofol combined with fentanyl is the most widely used in clinical practice.
      But intravenous general anesthesia can lead to hemodynamic fluctuations and an increase in
      anesthesiation-related complications such as longer stays in the hospital after surgery.
      Complications related to sedation and analgesia have attracted increasing attention in recent
      years. Studies have shown that most of the adverse events in endoscopy are related to the
      sedation and analgesia drugs used. With the successful application of patient-controlled
      analgesia (PCA) in the field of postoperative analgesia, this technique has also been used in
      the sedation and analgesia of gastroenteroscopy in recent years. Propofol has the
      characteristics of quick action, short time of action and rapid recovery, so it is very
      suitable for the anesthesia and sedation of painless abortion and painless gastroenteroscopy.
      Remifentanil, as an opioid μ receptor agonist, is easily hydrolyzed rapidly by non-specific
      esterases in plasma and tissues due to the ester bond contained in its chemical structure.
      Therefore, it has unique pharmacokinetic characteristics such as rapid intravenous injection,
      small volume of distribution, rapid clearance after drug withdrawal, no accumulation,
      metabolism is not affected by liver and kidney function, and has been widely used in various
      surgeries in recent years, especially in the anesthesia of short surgeries.
    

Intervention name(s): Controlled analgesia/sedation; Intravenous combined anesthesia
Intervention type(s): Procedure; Procedure
Intervention description(s): During the pre anesthesia assessment, explain in detail to the patient the usage of the self-control pump and confirm that each patient can master it. Firstly, connect the self-control analgesic pump with a loading dose of 3 ml. Then, continuously pump in a mixture of propofol and remifentanil at a speed of 0.1 ml/kg/h. After the loading dose is completed, the examination can begin. During the operation, press the self-control handle according to the patient's sensation. Each press can quickly push 1ml of the medication, with a locking time of 1 minute; Intravenous slow infusion of fentanyl 1 μ G/kg, midazolam 0.02mg/kg, slowly administer propofol 0.8-1mg/kg after 2 minutes (time greater than 60 seconds), and start the examination when the patient's consciousness disappears and they do not respond. During the surgery, propofol is interrupted to maintain the auditory evoked potential index (AAI) between 30-40.
Intervention MeSH terms: Anesthetics
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Participant)
Primary purpose: Supportive Care