Fakheri H T, Kiasari A Z, Taghvaii T, Hosseini V, Mohammadpour R A, Nasrollah A, Kabirzadeh A, Shahmohammadi S
Department of Gastroenterology, Imam Khomeini Hospital, Mazandaran University of Medical Sciences, Sari, Iran.
Pak J Biol Sci. 2010 Feb 15;13(4):152-7. doi: 10.3923/pjbs.2010.152.157.
The aim of this study was to evaluate the prevalence of hypoxia related to midazolam sedation during upper gastrointestinal endoscopy. This single blind randomized placebo control clinical trial, carried out on 180 patients who referred to endoscopy clinic at Imam Khomeini Hospital for selective upper gastrointestinal endoscopy from April to July in 2008. Informed consents obtained from all participants. Patients under 18-years-old, obese, previous history of asthma, COPD and cigarette smoking were excluded. Arterial hemoglobin saturation controlled by finger probe pulse oximetry. After pharyngeal lidocaine spray, midazolam was administered intravenously in case group and patients in controlled group received placebo. Demographic characteristics and other variables were recorded in a questionnaire and data analyzed using SPSS software. Gastrointestinal disturbances and epigastric pain were major indications of endoscopies. The most common endoscopic diagnoses were deudonitis, esophagitis or gastroesophagial reflux. No patients had any serious episode of hypoxia and the incidence of mild hypoxia was not significant in both studied group (p = 0.823). There was no significant difference in arterial oxygen saturation recorded by the three endoscopists (p = 0.734). Our data showed that optimal dose of sedation had no hypoxia. So that, we recommend sedative endoscopy in patients without risk factors for hypoxia.
本研究的目的是评估上消化道内镜检查期间与咪达唑仑镇静相关的低氧血症患病率。这项单盲随机安慰剂对照临床试验，于2008年4月至7月对180名转诊至伊玛目霍梅尼医院内镜检查门诊进行选择性上消化道内镜检查的患者开展。所有参与者均签署了知情同意书。排除18岁以下、肥胖、有哮喘、慢性阻塞性肺疾病病史及吸烟史的患者。通过手指探头脉搏血氧饱和度仪控制动脉血红蛋白饱和度。在咽部喷洒利多卡因后，试验组静脉注射咪达唑仑，对照组患者接受安慰剂。通过问卷记录人口统计学特征和其他变量，并使用SPSS软件进行数据分析。胃肠道紊乱和上腹部疼痛是内镜检查的主要指征。最常见的内镜诊断为十二指肠炎、食管炎或胃食管反流。两组均无患者发生任何严重低氧血症事件，轻度低氧血症的发生率也无显著差异（p = 0.823）。三位内镜医师记录的动脉血氧饱和度无显著差异（p = 0.734）。我们的数据表明，最佳镇静剂量不会导致低氧血症。因此，我们建议在无低氧血症危险因素的患者中进行镇静内镜检查。
