Clinical trial: a randomized, study comparing meperidine (pethidine) and fentanyl in adult gastrointestinal endoscopy
Clinical trial: a randomized, study comparing meperidine (pethidine) and fentanyl in adult gastrointestinal endoscopy
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DOI：
10.1111/j.1365-2036.2009.03943.x
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发表时间：
2009-04-15
影响因子：
7.6
通讯作者：
Rothstein, R. I.
中科院分区：
文献类型：
--
作者：
Robertson, D. J.;Jacobs, D. P.;Rothstein, R. I.
在胃肠镜检查中选择哌替啶和芬太尼镇静的证据很少。比较哌替啶和芬太尼在操作时间和镇痛方面的差异。单中心随机对照试验。患者接受麻醉剂剂量和咪达唑仑，由不知道麻醉剂分配的主治内镜医师决定。然后记录内镜检查和恢复时间。主要结局是总手术时间，定义为内窥镜检查时间加恢复时间。在出院前通过视觉模拟评分法（VAS）评估患者的不适程度。共有55例患者随机分配至哌替啶组[44例结肠镜检查和11例食管胃镜检查（EGD）]，56例患者随机分配至芬太尼组[45例结肠镜检查和11例EGD）。芬太尼组的总手术时间（平均= 87.7 min）短于哌替啶组（平均= 102.9 min）（P = 0.05）。芬太尼组的平均恢复时间（63.0 min）短于哌替啶组（76.2 min）（P = 0.07）解释了两组之间的差异。根据术后疼痛评分，哌替啶组（平均值= 1.99）与芬太尼组（平均值= 2.86，P = 0.03）相比疼痛程度较轻。芬太尼通过缩短恢复时间缩短了总手术时间。麻醉剂选择的简单改变可以提高内窥镜检查的效率。
There is little evidence to guide choice between meperidine (pethidine) and fentanyl for sedation for gastrointestinal endoscopy.To compare meperidine with fentanyl in terms of procedure time and analgesia.Single centre randomized controlled trial. Patients received narcotic doses and midazolam at the discretion of the attending endoscopist who was unaware of narcotic assignment. Endoscopy and recovery times were then recorded. The main outcome was total procedure time, defined as endoscopy time plus recovery time. Patient discomfort was assessed prior to discharge via visual analogue scale (VAS).In total, 55 patients were randomized to meperidine [44 colonoscopy and 11 esophagogastroduodenoscopy (EGD)] and 56 to fentanyl (45 colonoscopy and 11 EGD). Total procedure time was shorter for those receiving fentanyl (mean = 87.7 min) than for those receiving meperidine (mean = 102.9 min) (P = 0.05). The difference between the groups was explained by a shorter mean recovery time in the fentanyl group (63.0 min) than in the meperidine group (76.2 min) (P = 0.07). Based on post procedure pain scores, examinations with meperidine (mean = 1.99) were less painful when compared with those receiving fentanyl (mean = 2.86, P = 0.03).Fentanyl shortened total procedure time by reducing recovery time. A simple change in narcotic choice could increase endoscopy unit efficiency.