Kauling Ana Laura Colle, Locks Giovani de Figueiredo, Brunharo Guilherme Muriano, da Cunha Viriato João Leal, de Almeida Maria Cristina Simões
Universidade Federal de Santa Catarina (UFSC), Florianópolis, SC, Brazil.
Rev Bras Anestesiol. 2010 Nov-Dec;60(6):577-83, 320-3. doi: 10.1016/S0034-7094(10)70072-6.
Conscious sedation in the ambulatory setting albeit common is not risk-free. The present study aimed at evaluating the blood pressure, heart rate and peripheral oxygen saturation in patients submitted to conscious sedation for upper digestive endoscopy performed by endoscopists.
A total of 105 patients of both sexes were selected, aged 18 and older, physical status ASA I to III, submitted to upper digestive endoscopy under conscious sedation. The patients were monitored through noninvasive blood pressure measurements, pulse oximetry and heart rate recorded before, during and after the examination. The sedation was carried out with midazolam or meperidine.
The variations in oxygen saturation, blood pressure and heart rate throughout time were not statistically significant. However, an incidence of hypoxia of 41.9% was observed; 53.3% of the cases presented arterial hypotension and 25.6% presented tachycardia. Obese patients were more prone to hypoxia and hypotension than those non obese.
The occurrence of hypoxia and arterial hypotension is common in upper digestive endoscopic examinations under conscious sedation when midazolam and meperidine are associated. Obese patients demonstrated to be more susceptible to hypoxemia and arterial hypotension.
门诊环境下的清醒镇静虽常见但并非无风险。本研究旨在评估由内镜医师实施清醒镇静进行上消化道内镜检查的患者的血压、心率和外周血氧饱和度。
共选取105例年龄18岁及以上、身体状况为美国麻醉医师协会（ASA）分级I至III级的男女患者，在清醒镇静下接受上消化道内镜检查。通过无创血压测量、脉搏血氧饱和度测定和心率监测对患者在检查前、检查期间和检查后的情况进行记录。镇静采用咪达唑仑或哌替啶。
血氧饱和度、血压和心率随时间的变化无统计学意义。然而，观察到低氧发生率为41.9%；53.3%的病例出现动脉低血压，25.6%的病例出现心动过速。肥胖患者比非肥胖患者更容易发生低氧和低血压。
在联合使用咪达唑仑和哌替啶进行清醒镇静的上消化道内镜检查中，低氧和动脉低血压的发生较为常见。肥胖患者表现出更易发生低氧血症和动脉低血压。
