Abstract: 【Abstract】Objective To investigate the efficacy and safety of conscious sedation (CS) in the operation of peritoneal dialysis (PD) catheterization. Methods Patients undergoing catherization for PD by surgical incision treated in Peking University International Hospital during the period from January 2017 to May 2020 were enrolled in this study. Patients were divided into two groups according to the anesthesia method: group A, intramuscular injection of pethidine hydrochloride and promethazine hydrochloride before operation combined with local infiltration anesthesia during operation; group B, one of the three analgesics, fentanyl (subgroup B1), sufentanil (subgroup B2) or remifentanil (subgroup B3) intravenously at the beginning of operation for conscious sedation combined with local infiltration anesthesia. Adverse reactions, clinical findings, and peri-operative blood pressure, heart rate and pain score were compared between the two groups. Results A total of 94 patients, 53 cases in group A and 41 cases in group B, were enrolled in this study. There were no differences in demographic data and laboratory examinations between the two groups. The proportion of patients with high anesthesia risk (grade IV) based on the ASA assessment was 58.5% and 68.3% in group A and group B respectively (P=0.330). The proportion of intraoperative pain was lower in group B than in group A (17% vs. 39.6%, P=0.018). There were no significant differences in rate of postoperative pain, resting pain score and exercise pain score between the two groups. Five cases in group A (9.4%) had adverse reactions, including gastrointestinal reactions in 3 cases, hypotension in one case, and consciousness disturbance in one case; two cases in group B (4.8%) had gastrointestinal reactions. However, there was no significant difference in the incidence of overall adverse reactions between the two groups (P=0.395). No significant differences in analgesic effects and gastrointestinal reactions were found among the three subgroups in group B (P> 0.05). Conclusion Patients undergoing PD catheterization are at high risk of anesthesia. Conscious sedation anesthesia had better analgesic effect and safety, complying with the concept of comfortable medical treatment.

Key words: Peritoneal dialysis catheterization, Conscious sedation, Anesthesia