Abstract: Objective To observe the application of propofol combined with etomidate in painless gastrointestinal endoscopy for the elderly, and evaluate the clinical effect and safety of the two drugs combined. Methods A prospective, randomized, controlled study was conducted among 96 elderly patients selected and randomly divided into two groups according to different anesthesia methods admitted to the Second People's Hospital of Fengrun District, Tangshan City, Hebei Province for painless gastroscopy from January 2019 to January 2020. 48 cases in the group A were given propofol combined with etomidate anesthesia, while 48 cases in the group B were given propofol anesthesia. After the examination, the anesthetic effect(anesthesia induction time, recovery time, directional recovery time), serological indicators(epinephrine, norepinephrine, cortisol)and adverse reactions were compared between the two groups. Results(1)Anesthesia induction time, recovery time and orientation recovery time of group B were significantly lower than those of group A(P<0.05).(2)Compared with that before examination in the same group, the serum cortisol, epinephrine and norepinephrine levels in the two groups were significantly increased(P<0.05)and the serum levels of epinephrine, norepinephrine and cortisol in group B were lower than those in group A(P<0.05).(3)The incidence of adverse reactions in group B was significantly lower than that in group A(P<0.05). Conclusion The application of propofol combined with etomidate anesthesia in elderly patients with painless gastroenteroscopy can improve the anesthetic effect, improve the stress reaction and reduce the incidence of adverse reactions.

Key words: propofol, etomidate, painless gastroscopy, clinical effect, security