Daneshmend T K, Bell G D, Logan R F
Department of Therapeutics, University Hospital, Nottingham.
Gut. 1991 Jan;32(1):12-5. doi: 10.1136/gut.32.1.12.
A postal questionnaire inquiring about routine sedation and premedication practice for upper gastrointestinal endoscopy was sent to 1048 doctors. Of 665 appropriate returns, 81% were from consultant physicians and surgeons. Most endoscopists (90%) reported using an intravenous benzodiazepine for at least three quarters of endoscopies and 54% of physicians and 69% of surgeons always did so. Midazolam was the intravenous sedative used by a third of all respondents and 13% also used an additional intravenous agent, usually pethidine. Over the previous two years a total of 119 respiratory arrests, 37 cardiac arrests, and 52 deaths were identified. Adverse outcomes were reported more frequently by consultant physicians, by those who 'titrated' the intravenous sedative, and by those who used an additional intravenous agent, but were reported equally frequently by endoscopists using midazolam and endoscopists using diazepam. There is an urgent need for a prospective study to identify the circumstances and risk factors associated with adverse outcomes related to endoscopy.
一份关于上消化道内镜检查常规镇静和术前用药情况的邮政调查问卷被寄给了1048名医生。在665份有效回复中，81%来自内科和外科顾问医生。大多数内镜检查医师（90%）报告称，至少四分之三的内镜检查使用静脉注射苯二氮䓬类药物，54%的内科医生和69%的外科医生一直如此。三分之一的受访者使用咪达唑仑作为静脉镇静剂，13%的人还使用了另外一种静脉药物，通常是哌替啶。在过去两年中，共发现119例呼吸骤停、37例心脏骤停和52例死亡。顾问医生、“滴定”静脉镇静剂的医生以及使用另外一种静脉药物的医生报告不良后果的频率更高，但使用咪达唑仑的内镜检查医师和使用地西泮的内镜检查医师报告不良后果的频率相同。迫切需要进行一项前瞻性研究，以确定与内镜检查相关不良后果有关的情况和危险因素。
