Ferson David, Thakar Dilip, Swafford Joseph, Sinha Ashish, Sapire Kenneth, Arens James
Department of Anesthesiology and Cardiology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA.
J Cardiothorac Vasc Anesth. 2003 Aug;17(4):443-6. doi: 10.1016/s1053-0770(03)00147-2.
To describe the use of either deep intravenous sedation with propofol or light sedation with midazolam and topical anesthesia during transesophageal echocardiography (TEE) and to report the incidence of respiratory complications and their management.
Retrospective study from March 2000 through August 2002.
Single institution, specialized cancer center.
All patients undergoing TEE examination in the specified time period (n = 42).
Eight patients received light sedation and 34 patients received deep intravenous sedation with propofol. An airway event occurred in one patient in the light sedation group and in six patients in the deep sedation group. The patient in the light sedation group was managed with the use of a face-mask and a manual resuscitation bag. All airway events in the deep sedation group were managed successfully using the laryngeal mask airway (LMA).
Deep sedation with intravenous propofol can provide both excellent patient comfort and optimal conditions for TEE examination, particularly in patients who may require more lengthy procedures or in whom other techniques have failed. Although the incidence of respiratory depression was higher in patients receiving deep sedation with propofol than in patients who were lightly sedated (17.6% versus 12.5%, respectively), all six patients who had respiratory depression while under deep sedation with propofol were successfully ventilated using the LMA trade mark, without the need to remove the TEE probe and without terminating the examination prematurely. In contrast, in the one patient in the light sedation group who had respiratory depression, the TEE probe had to be removed to ventilate the patient via a face mask, and the procedure was cancelled.
描述在经食管超声心动图（TEE）检查期间使用丙泊酚进行深度静脉镇静或使用咪达唑仑进行浅镇静及局部麻醉的情况，并报告呼吸并发症的发生率及其处理方法。
2000年3月至2002年8月的回顾性研究。
单一机构，专业癌症中心。
在特定时间段内接受TEE检查的所有患者（n = 42）。
8例患者接受浅镇静，34例患者接受丙泊酚深度静脉镇静。浅镇静组有1例患者发生气道事件，深度镇静组有6例患者发生气道事件。浅镇静组的患者通过使用面罩和手动复苏袋进行处理。深度镇静组的所有气道事件均使用喉罩气道（LMA）成功处理。
静脉注射丙泊酚进行深度镇静可为TEE检查提供极佳的患者舒适度和最佳条件，特别是对于可能需要更长手术时间或其他技术失败的患者。虽然接受丙泊酚深度镇静的患者呼吸抑制发生率高于浅镇静患者（分别为17.6%和12.5%），但所有在丙泊酚深度镇静期间发生呼吸抑制的6例患者均使用LMA商标成功通气，无需移除TEE探头且无需过早终止检查。相比之下，浅镇静组中1例发生呼吸抑制的患者，必须移除TEE探头以便通过面罩为患者通气，并且取消了该检查。
