Anesthetic effect and adverse reactions of propofol in painless gastrointestinal endoscopy in patients with different Child-Pugh classification of liver cirrhosis

Objective To investigate the anesthetic effect and adverse reactions of propofol in painless gastrointestinal endoscopy in patients with varying degrees of liver cirrhosis. Methods A total of 342 patients with liver cirrhosis who underwent gastrointestinal endoscopy under propofol anesthesia in The Affiliated Hospital of Logistics University of Chinese People's Armed Police Forces from February 2015 to August2017 were enrolled. According to the Child-Pugh class before surgery, the patients were divided into Child-Pugh A Group ( n = 224) , Child-Pugh B group ( n = 94) , and Child-Pugh C Group ( n = 24) . The three groups were compared in terms of anesthetic effect and adverse reactions. An analysis of variance was used for comparison of continuous data between multiple groups, and the SNK-q test was used for further comparison between any two groups; the chi-square test or the Kruskal-Wallis H rank sum test was used for comparison of categorical data between multiple groups, and a Ridit analysis was used for further comparison between any two groups. Results Compared with the Child-Pugh A group and the Child-Pugh B group, the Child-Pugh C group had a significantly smaller amount of propofol used ( F =4. 401, P = 0. 017) and a significantly shorter time of loss of consciousness ( F = 9. 440, P = 0. 001) . No patient experienced adverse reactions such as allergy to propofol, propofol infusion syndrome, and convulsion-like reactions. There were no significant differences in the incidence rates of pain at the injection site, arrhythmia, and respiratory depression between the three groups ( all P > 0. 05) . There was a significant difference in the reduction in blood pressure between the three groups ( H = 3. 795, P < 0. 001) , and the Child-Pugh B group had significantly lower blood pressure than the other two groups ( both P < 0. 05) . Conclusion Propofol has a safe anesthetic effect in painless gastrointestinal endoscopy in patients with varying degrees of liver cirrhosis and does not have serious adverse effects. Patients with poorer liver function tend to have a smaller amount of propofol used, and the change in blood pressure should be taken seriously during surgery.