CONSCIOUS SEDATION FOR GASTROSCOPY - PATIENT TOLERANCE AND CARDIORESPIRATORY PARAMETERS
CONSCIOUS SEDATION FOR GASTROSCOPY - PATIENT TOLERANCE AND CARDIORESPIRATORY PARAMETERS
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DOI：
10.1016/0016-5085(95)90441-7
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发表时间：
1995-03-01
期刊：
影响因子：
29.4
通讯作者：
FRIED, M
中科院分区：
文献类型：
--
作者：
FROEHLICH, F;SCHWIZER, W;FRIED, M
背景/目的：大多数患者在进行胃镜检查时接受清醒镇静。然而，最常使用的低剂量静脉咪达唑仑和局部利多卡因联合给药对患者耐受性的获益仍不明确，且未显示其超过心肺风险。为了解决这些问题，进行了一项随机、双盲、安慰剂对照的前瞻性研究。研究方法：200例接受诊断性胃镜检查的门诊患者被分配接受（1）咪达唑仑（35 μ g/kg）和利多卡因喷雾剂（100 mg），（2）咪达唑仑和安慰剂利多卡因，（3）安慰剂咪达唑仑和利多卡因，或（4）安慰剂咪达唑仑和安慰剂利多卡因。结果如下：与安慰剂咪达唑仑和安慰剂利多卡因相比，耐受性（视觉模拟量表，0-100分; 0，极好; 100，无法忍受）在第1组中提高了23分（95%置信区间，15-32），在第2组中提高了15分（95%置信区间，7-24），在第3组中提高了10分（95%置信区间，2-18）。年龄增加（P < 0.001）、低焦虑（P < 0.001）和男性（P < 0.03）与患者耐受性较好相关，但与健忘症无关。氧饱和度下降（
Background/Aims: Most patients receive conscious sedation for gastroscopy. However, the benefit of the most often used combination of low-dose intravenous midazolam and topical lidocaine on patient tolerance remains poorly defined and has not been shown to outweigh cardiorespiratory risks. To respond to these issues, a randomized, double-blind, placebo-controlled prospective study was performed. Methods: Two hundred outpatients undergoing diagnostic gastroscopy were assigned to receive either (1) midazolam (35 mu g/kg) and lidocaine spray (100 mg), (2) midazolam and placebo lidocaine, (3) placebo midazolam and lidocaine, or (4) placebo midazolam and placebo lidocaine. Results: Tolerance (visual analogue scale, 0-100 points; 0, excellent; 100, unbearable) improved as compared with placebo midazolam and placebo lidocaine by 23 points (95% confidence interval, 15-32) in group 1, 15 points (95% confidence interval, 7-24) in group 2, and 10 points (95% confidence interval, 2-18) in group 3. Increasing age (P < 0.001), low anxiety (P < 0.001), and male sex (P < 0.03), but not amnesia, were associated with better patient tolerance. Oxygen desaturation (