Optimizing sedation in gastroscopy: a study on the etomidate/propofol mixture ratio.

Area of Science:

• Anesthesiology
• Pharmacology
• Gastroenterology

Background:

• Propofol and etomidate are common sedative agents with distinct profiles.
• Optimal ratios for combining propofol and etomidate lack consensus.
• Gastroscopy sedation requires safe and effective anesthetic agents.

Purpose of the Study:

• To determine the optimal ratio of etomidate and propofol for gastroscopy.
• To evaluate the hemodynamic stability and adverse events of different sedative ratios.
• To establish a safe and effective sedation protocol for endoscopic procedures.

Main Methods:

• Prospective, double-blinded, randomized controlled trial with 162 patients.
• Three groups: propofol alone (P), etomidate-propofol 1:2 (EP1), and etomidate-propofol 1:1 (EP2).
• Monitored Mean Arterial Pressure (MAP), heart rate, SpO2, and adverse events.

Main Results:

• The EP2 group (1:1 ratio) showed higher MAP at T2 compared to P and EP1 groups (p < 0.05).
• EP2 group had significantly lower hypotension incidence (11.1%) versus P (50%) and EP1 (31.5%).
• EP2 group experienced significantly less injection pain compared to P and EP1 groups (p < 0.05).

Conclusions:

• A 1:1 ratio of etomidate and propofol, with dezocine, provides hemodynamic stability for gastroscopy.
• This combination significantly reduces the incidence of hypotension and injection pain.
• The 1:1 etomidate-propofol mixture is a safe and effective option for painless gastroscopy.