Mizuno Ju, Matsuki Michiko, Gouda Yoshinori, Nishiyama Tomoki, Hanaoka Kazuo
Pain Relief Center, Department of Anesthesiology, Faculty of Medicine, University of Tokyo, Tokyo 113-8655.
Masui. 2003 Sep;52(9):976-80.
Cardiorespiratory adverse effects are often observed in patients undergoing upper gastrointestinal endoscopy with sedation. In this study, we examined hemodynamics, oxygen saturation and memory during upper gastrointestinal endoscopy under sedation with intravenous midazolam.
Eight healthy outpatients without any obvious complications received intravenous midazolam 5 mg for sedation for upper gastrointestinal endoscopy. Blood pressure, heart rate and percutaneous arterial oxygen saturation (SpO2) were measured before, during and after endoscopy. After the arousal by intravenous flumazenil, we inquired the patients about the level of memory during the endoscopy.
Blood pressure decreased significantly two minutes after midazolam administration, but increased significantly after the insertion of an endoscope which was not different from the control value. Heart rate increased significantly one and three minutes after the insertion of the endoscope. SpO2 decreased significantly after midazolam administration and stayed at around 95%. No patients remembered the procedure.
Sedation with intravenous midazolam during upper gastrointestinal endoscopy is useful to control the cardiovascular responses, and to obtain amnesia. However, a decrease in SpO2 should be watched carefully.
在接受镇静的上消化道内镜检查患者中,常观察到心肺不良反应。在本研究中,我们检测了静脉注射咪达唑仑镇静下上消化道内镜检查期间的血流动力学、血氧饱和度和记忆力。
8名无明显并发症的健康门诊患者接受静脉注射5mg咪达唑仑用于上消化道内镜检查镇静。在内镜检查前、检查期间和检查后测量血压、心率和经皮动脉血氧饱和度(SpO2)。在静脉注射氟马西尼唤醒患者后,我们询问患者内镜检查期间的记忆水平。
咪达唑仑给药后两分钟血压显著下降,但在内镜插入后显著升高,与对照值无差异。内镜插入后1分钟和3分钟心率显著增加。咪达唑仑给药后SpO2显著下降,维持在95%左右。没有患者记得该操作过程。
上消化道内镜检查期间静脉注射咪达唑仑镇静有助于控制心血管反应并实现遗忘。然而,应密切观察SpO2的下降情况。