Optimal dosage and safety evaluation of alfentanil combined with propofol for painless colonoscopy in elderly patients
阿芬太尼复合丙泊酚在老年患者无痛肠镜检查中的最佳剂量及安全性评价

摘要

目的 探讨阿芬太尼复合丙泊酚用于老年患者无痛结肠镜检查的最佳剂量，并比较其与等效芬太尼的麻醉效果及安全性。方法 采用双盲、随机、对照试验设计，纳入200例ASAⅠ-Ⅲ级、65-80岁患者，分为剂量探索阶段（AF5、AF7、AF9 vs F组）和验证阶段（A vs B组）。记录生命体征、恢复时间及简易智能精神状态检查量表（MMSE）评分。结果 AF7组（7 μg/kg）较F组显著缩短诱导时间（104.63±14.52 vs 120.87±20.34 s，p<0.001）、睁眼时间（35.10±24.64 vs 69.57±39.03 s，p=0.003）及离室时间（18.90±3.85 vs 23.40±4.88 min，p=0.012）。A组（AF7）术后5分钟MMSE评分高于B组（25.33±2.18 vs 24.48±1.45，p=0.032）。结论 阿芬太尼7 μg/kg复合丙泊酚可优化老年患者无痛肠镜的麻醉管理，具有更优的恢复质量与认知保护作用。

Abstract

Objective To investigate the optimal dose of alfentanil combined with propofol for painless colonoscopy in elderly patients and to compare its anesthetic efficacy and safety with that of equivalent fentanyl.
Methods A double-blind, randomized, controlled trial was conducted. Two hundred patients aged 65-80 years and in ASA physical status I-III were enrolled in the trial. The patients were divided into a dose-finding phase (AF5, AF7, AF9 vs F group) and a validation phase (A vs B group). Vital signs, recovery time, and Mini-Mental State Examination (MMSE) scores were recorded.
Results Group A (AF7) (7 μg/kg) significantly shortened induction time (104.63±14.52 vs 120.87±20.34 s, p<0.001), eye opening time (35.10±24.64 vs 69.57±39.03 s, p=0.003), and chamber exit time (18.90±3.85 vs 23.40±4.88 min, p=0.012) compared with group F. Group A (AF7) had significantly higher MMSE scores 5 minutes after surgery than group B (25.33±2.18 vs 24.48±1.45, p=0.032).
Conclusion   Alfentanil 7 μg/kg combined with propofol can optimize anesthetic management for painless colonoscopy in elderly patients, resulting in improved recovery quality and cognitive protection.