Retrospective Study
Copyright ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Jul 27, 2025; 17(7): 106901
Published online Jul 27, 2025. doi: 10.4240/wjgs.v17.i7.106901
Etomidate-propofol combination in painless gastrointestinal endoscopy for elderly patients: A comparative study
Ying-Yan Zhang
Ying-Yan Zhang, Department of Anesthesiology, People’s Hospital of Wuhan Economic and Technological Development Zone (Hannan District), Wuhan 430090, Hubei Province, China
Author contributions: Zhang YY designed the research and wrote the first manuscript; Zhang YY contributed to conceiving the research and analyzing data; Zhang YY conducted the analysis and provided guidance for the research.
Institutional review board statement: This study was approved by the Ethic Committee of People’s Hospital of Wuhan Economic and Technological Development Zone (Hannan District), on October 15, 2024.
Informed consent statement: Data was de-identified and retrospectively collected, and therefore informed consent was not required from each patient.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: The datasets used and analyzed during the current study are available from the corresponding author on reasonable request at zyy19830515@163.com.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ying-Yan Zhang, Department of Anesthesiology, People’s Hospital of Wuhan Economic and Technological Development Zone (Hannan District), No. 275 Xingcheng Avenue, Wuhan 430090, Hubei Province, China. zyy19830515@163.com
Received: March 12, 2025
Revised: April 14, 2025
Accepted: May 28, 2025
Published online: July 27, 2025
Processing time: 133 Days and 3.6 Hours
Abstract
BACKGROUND

Elderly patients often display age-related physiological decline, which increases their susceptibility to complications during medical procedures. Therefore, it is clinically imperative to refine anesthetic protocols for painless gastroscopy in this vulnerable population.

AIM

To explore the effects of the etomidate-propofol combination on anesthesia quality, compliance, and adverse reactions in elderly patients undergoing painless gastrointestinal endoscopy.

METHODS

A total of 103 elderly patients scheduled for painless gastrointestinal endoscopy at the Hospital of Wuhan Economic and Technological Development Zone (Hannan District) between October 2022 and October 2024 were enrolled. The participants were divided into a control group (n = 50) receiving propofol anesthesia and an observation group (n = 53) that received a combination of etomidate and propofol anesthesia. The anesthesia quality (including induction time, recovery time, and orientation recovery time), compliance, hemodynamic parameters (heart rate, oxygen saturation, systolic/diastolic blood pressure), adverse reactions (muscle tremors, injection pain, respiratory depression, hypotension, and nausea/vomiting), and analgesic and sedative effects [evaluated using the visual analog scale (VAS) and Ramsay score] were comparatively analyzed.

RESULTS

The observation group had significantly shorter anesthesia induction, recovery, and orientation recovery times than the control group. Moreover, the observation group showed higher compliance; greater hemodynamic stability at preanesthesia (T0), during anesthesia (T1), and postrecovery (T2) time points; and a significantly lower incidence of adverse reactions. The VAS and Ramsay scores at 5, 30, and 60 minutes after anesthesia recovery were also significantly lower in the observation group than in the control group.

CONCLUSION

The etomidate-propofol combination for painless gastrointestinal endoscopy in elderly patients may provide superior anesthesia quality and improved compliance and safety, making it a promising approach for clinical application.

Keywords: Etomidate; Propofol; Painless gastrointestinal endoscopy; Anesthesia quality; Compliance; Adverse reactions

Core Tip: The choice of anesthesia plays a pivotal role in ensuring both safety and efficacy during painless gastroscopy. This study enrolled 103 elderly patients scheduled for painless gastrointestinal endoscopy and systematically compared propofol monotherapy with a combined etomidate-propofol regimen. Comprehensive evaluations of anesthesia quality, patient compliance, hemodynamic stability, adverse events, and sedation-analgesia efficacy demonstrated that the etomidate-propofol combination provides distinct clinical advantages for such patients. These results support its adoption as a preferred anesthetic strategy for elderly patients undergoing painless gastrointestinal endoscopy.