Effects of midazolam, propofol and etomidate on inflammatory stress and hemodynamics in patients with painless gastroscopy / 中国基层医药

ABSTRACT

Objective:To investigate the effects of midazolam, propofol and etomidate on inflammatory stress and hemodynamics in patients with painless gastroscopy.Methods:Eighty patients who underwent painless gastroscopy in Yinzhou People's Hospital of Ningbo from January 2017 to December 2018 were enrolled.The patients were divided into study group and control group according to the random number table method, with 40 cases in each group.The control group was given propofol+ midazolam intravenous anesthesia, and the study group received propofol+ etomidate+ midazolam for intravenous anesthesia.The inflammatory response index, stress response index and hemodynamic index were compared between the two groups before and after examination.Results:There were no statistically significant differences in the levels of tumor necrosis factor-α(TNF-α), interleukin-6(IL-6) and interleukin-10(IL-10) between the two groups before examination( t=0.389, 0.755, 0.106, all P>0.05), and the levels of TNF-α, IL-6 and IL-10 in the two groups were increased after examination(all P<0.05), and the levels of TNF-α, IL-6 and IL-10 in the study group were significantly lower than those in the control group, the differences were statistically significant[(227.61±25.77)nmol/L vs.(273.52±35.87)nmol/L, (39.89±5.60)ng/L vs.(50.47±5.92)ng/L, (61.33±7.63)μg/L vs.(73.41±8.54)μg/L, (23.58±3.07)μg/L vs.(30.94±4.24)μg/L, t=6.574, 8.211, 6.671, 8.892, all P<0.05]. There were no statistically significant differences in cortisol(Cor), aldosterone(ALD), norepinephrine(NE), and angiotensin Ⅱ(AT-Ⅱ) levels between the two groups before examination( t=0.130, 0.386, 0.229, 0.481, all P>0.05), and the levels of Cor, ALD, NE and AT-Ⅱ in the two groups were increased after examination(all P<0.05). The Cor, ALD, NE and AT-Ⅱ levels in the study group were significantly lower than those in the control group, and the differences were statistically significant[(227.61±25.77)nmol/L vs.(273.52±35.87)nmol/L, (39.89±5.60)ng/L vs.(50.47±5.92)ng/L, (61.33±7.63)μg/L vs.(73.41±8.54)μg/L, (23.58±3.07)μg/L vs.(30.94±4.24)μg/L, t=6.574, 8.211, 6.671, 8.892, all P<0.05]. There were no statistically significant differences in heart rate(HR), systolic blood pressure(SBP) and diastolic blood pressure(DBP) between the two groups before examination( t=0.282, 0.216, 0.277, all P>0.05), and the HR, SBP and DBP levels of the control group were decreased after examination(all P<0.05). The levels of HR, SBP and DBP of the study group were significantly higher than those of the control group, and the differences were statistically significant[(75.22±5.80)times/min vs.(71.79±5.77)times/min, (83.91±4.52)mmHg vs.(79.55±5.14)mmHg, (128.56±6.67)mmHg vs.(121.68±5.02)mmHg, t=2.652, 4.029, 5.212, all P<0.05]. Conclusion:Intravenous anesthesia with propofol+ etomidate+ midazolam in patients with painless gastroscopy can effectively reduce the inflammatory response, stress response and stabilize hemodynamics.