CARDIOVASCULAR TOLERANCE AND AUTONOMIC NERVOUS RESPONSES IN UNSEDATED UPPER GASTROINTESTINAL SMALL-CALIBER ENDOSCOPY: A COMPARISON BETWEEN TRANSNASAL AND PERORAL PROCEDURES WITH NEWLY DEVELOPED MOUTHPIECE
CARDIOVASCULAR TOLERANCE AND AUTONOMIC NERVOUS RESPONSES IN UNSEDATED UPPER GASTROINTESTINAL SMALL-CALIBER ENDOSCOPY: A COMPARISON BETWEEN TRANSNASAL AND PERORAL PROCEDURES WITH NEWLY DEVELOPED MOUTHPIECE
复制标题
DOI：
10.1111/j.1443-1661.2010.01064.x
复制
发表时间：
2011-01-01
影响因子：
5.3
通讯作者：
Joh, Takashi
中科院分区：
文献类型：
--
作者：
Kataoka, Hiromi;Hayano, Junichiro;Joh, Takashi
背景：小口径内镜下经鼻食管胃管镜检查（EGD）对心血管系统的压力较小，患者耐受性良好。ENDO LEADER是一种新开发的用于小口径内窥镜经口EGD的吸嘴，有望减轻患者压力。我们比较了患者的接受程度，心血管耐受性和自主神经反应之间的经鼻和经口EGD与ENDO LEADER.Patients和方法：共130例患者（经鼻组，77，经口组，53）。监测脉率（P）、血压（BP）和外周血氧饱和度（SpO（2））。还评估了EGD的接受程度。自主神经反应进行了评估，通过分析心率变异性，使用的高频分量（HF）和低频高频功率比（LF/HF）的心脏迷走神经活动和交感神经activity.Results的指标：分析患者接受显示两组之间没有差异，除了关于鼻疼痛。EGD检查前和检查期间的BP和P升高在口服组中显著更高。尽管咽喉疼痛和总体耐受性评分与Δ BP和Δ P显著相关，但与鼻部疼痛评分无相关性。心率变异性分析显示，在peroral组的心率显着增加，但有两个groups.Conclusions之间没有差异，在Delta HF或Delta LF/HF：患者接受之间没有显着差异经鼻和经口与ENDO LEADER组;然而，经鼻EGD似乎是较少的压力交感神经系统，导致血压，P和心率的较小的升高。
Background:Transnasal esophagogastroduodenoscopy (EGD) with small-caliber endoscopy appears to be less stressful to the cardiovascular system and has good patient tolerance. ENDO LEADER, a newly developed mouthpiece for peroral EGD with small-caliber endoscopy, is expected to reduce patient stress. We compared the patient acceptance, cardiovascular tolerance and autonomic nervous responses between transnasal EGD and peroral EGD with ENDO LEADER.Patients and Methods:A total of 130 patients (transnasal group, 77; peroral group, 53) were enrolled. Pulse rate (P), blood pressure (BP), and peripheral blood oxygen saturation (SpO(2)) were monitored. Acceptance of EGD was also assessed. Autonomic nervous responses were evaluated through analysis of heart rate variability using amplitude of the high-frequency component (HF) and low-frequency-to-high-frequency power ratio (LF/HF) as indices of cardiac vagal activity and sympathetic activity, respectively.Results:Analysis of patient acceptance showed no differences between the two groups, except with regard to nasal pain. Increases in BP and P between before and during EGD examination were significantly higher in the peroral group. Although throat pain and overall tolerance scores were significantly correlated with Delta BP and Delta P, no correlations with nasal pain score were noted. Heart rate variability analysis revealed that heart rate increased significantly in the peroral group, but there were no differences in Delta HF or Delta LF/HF between the two groups.Conclusions:Patient acceptance was not significantly different between the transnasal and peroral with ENDO LEADER groups; however, transnasal EGD appears to be less stressful to the sympathetic nervous system, leading to smaller elevations in BP, P and heart rate.