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伴随音乐疗法下结肠镜检查的改良程序

Improved procedure of colonoscopy under accompanying music therapy.

作者信息

Schiemann Uwe, Gross M, Reuter R, Kellner H

机构信息

Medizinische Poliklinik, Klinikum Innenstadt, Ludwig-Maximilians-Universität Muenchen, Pettenkoferstr. 8a, D-80336 Muenchen, Germany.

出版信息

Eur J Med Res. 2002 Mar 28;7(3):131-4.

Abstract

BACKGROUND

Administration of sedatives and analgetics during colonoscopy includes the risk for arterial hypotension and respiratory depression. The aim of this study was to assess whether music therapy increases patients tolerance and reduces the need of analgo-sedative premedication.

METHODS

146 consecutive patients were examined in a randomized, prospective study. Colonoscopy was performed under intravenous administration with titrated dosages of midazolam and pethidin. Oxygen was given in cases of blood desaturation below values of 90%. Patients younger than 18 and older than 80 years, patients with history of partial colectomy, gastrectomy or hysterectomy and patients with colonic tumorous or inflammatory stenosis were excluded. 60 patients underwent conventional procedure (Group A), whereas 59 patients received additional music therapy (Group B). Time required to reach the cecum (examination time) was measured and the rate of successful colonoscopies was determined.

RESULTS

Most of the patients required sedation with midazolam in both groups (97 vs. 93%), whereas more group A patients required analgesia with pethidin than group B patients (43 vs. 31%, p<0.05). Under music therapy the rate of completed colonoscopies was higher (group A 93%, group B 98%) and examination time was significantly accelerated (group A 22.8 +/- 14.6 min, group B 16.8 +/- 11.8 min, p<0.03).

CONCLUSIONS

Accompanying music therapy reduces requirement of analgesia during colonoscopy, favours completion of the procedure and shortens examination time. Music therapy seems to promote safer conditions for endoscopical practice and diminishs patients discomfort.

摘要

背景

结肠镜检查期间给予镇静剂和镇痛药存在动脉低血压和呼吸抑制的风险。本研究的目的是评估音乐疗法是否能提高患者的耐受性并减少镇痛镇静预处理的需求。

方法

在一项随机前瞻性研究中对146例连续患者进行了检查。结肠镜检查在静脉注射滴定剂量的咪达唑仑和哌替啶的情况下进行。血氧饱和度低于90%时给予氧气。排除年龄小于18岁和大于80岁的患者、有部分结肠切除术、胃切除术或子宫切除术病史的患者以及患有结肠肿瘤或炎性狭窄的患者。60例患者接受常规操作(A组),而59例患者接受额外的音乐疗法(B组)。测量到达盲肠所需的时间(检查时间)并确定结肠镜检查成功的比率。

结果

两组中大多数患者都需要使用咪达唑仑镇静(97%对93%),而A组需要使用哌替啶镇痛的患者比B组多(43%对31%,p<0.05)。在音乐疗法下,结肠镜检查完成率更高(A组93%,B组98%),检查时间明显加快(A组22.8±14.6分钟,B组16.8±11.8分钟,p<0.03)。

结论

伴随音乐疗法可减少结肠镜检查期间的镇痛需求,有利于完成操作并缩短检查时间。音乐疗法似乎为内镜操作创造了更安全的条件并减轻了患者的不适。

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