Journal of Practical Hepatology ›› 2024, Vol. 27 ›› Issue (2): 230-233.doi: 10.3969/j.issn.1672-5069.2024.02.018

• Liver cirrhosis • Previous Articles     Next Articles

Anesthesia of different concentrations of oxycodone and target-controlled infusion of propofol combination in patients with hepatitis B liver cirrhosis and esophageal variceal bleeding undergoing endoscopic sclerotherapy

Wang Hongxia, Xu Xiaoqian, Yu Mingshuai   

  1. Department of Anesthesiology, 416th Hospital of Nuclear Industry, Second Affiliated Hospital, Chengdu Medical College, Chengdu 610051, Sichuan Province, China
  • Received:2023-06-21 Online:2024-02-10 Published:2024-03-08

Abstract: Objective The aim of this study was to explore the anesthesia of different concentrations of oxycodone and target-controlled infusion of propofol combination in patients with hepatitis B liver cirrhosis (LC) and esophageal variceal bleeding (EVB) undergoing endoscopic sclerotherapy (EIS). Methods 87 patients with hepatitis B viral infection-induced LC and EVB were enrolled in our hospital between May 2021 and March 2023, and all patients underwent EIS. The patients were randomly divided into group A, B and C, receiving oxycodone at doses of 0.04 mg·kg-1, 0.08 mg·kg-1 and 0.12 mg·kg-1 for induction of anesthesia, and the combination of target-controlled infusion of propofol was continued. The parameters at immediately after disappearance of eyelash reflection (T1), at 1 min after endoscope placement (T2) and immediately after endoscope removal (T3) were recorded. The postoperative recovery quality and pain were evaluated by Stward’s scores and the visual analogue scale (VAS). Serum interleukin (IL-6) and tumor necrosis factor α (TNF-α) levels were detected by ELISA. Results At T1, T2 and T3, the effect compartment concentrations of propofol in group C were (3.0±0.2)μg/mL, (3.5±0.2)μg/mL and (3.1±0.6)μg/mL, all much lower than in group B or in group A; the dosage of propofol, the awakening time and the Stward’s socre in group C (388.3±27.1)mg, (11.8±2.0)min and (4.0±0.9), significantly different as compared to in group B or in group A; at 1 hour and 2 hours after EIS, the VAS scores in group C or group B were much lower than in group A(P<0.05); at 6 hours after operation, serum IL-6 and TNF-α levels in group B were (30.5±4.4)pg/mL and (16.3±1.9)pg/mL, both much lower than in group A or in group C; the incidences of nausea and vomiting, and respiratory depression in group C were 27.6% and 20.7%, much higher than 10.3% and 3.5% in group A (P<0.05) or 3.5% and 0.0% in group B(P<0.05). Conclusion We recommend oxycodone at dose of 0.08 mg·kg-1 for induction of anesthesia, and target-controlled infusion of propofol in patients with EVB during EIS, which might guarantee an relatively good anesthetic effect, and less complications.

Key words: Liver cirrhosis, Esophageal variceal bleeding, Endoscopic sclerotherapy, Propofol, Oxycodone, Anesthesia