Li Nai-Liang, Tseng Shiang-Chung, Hsu Che-Chang, Lai Wei-Ju, Su Hung-Chang, Cheng Tsun-I, Chen Wei-Chun, Peng Wen-Ling
Department of Anesthesiology, Koo Foundation, Sun Yat-Sen Cancer Center, Taipei, Taiwan.
Can J Gastroenterol. 2011 Feb;25(2):68-72. doi: 10.1155/2011/986130.
Supplmental oxygen is routinely given via nasal cannula (NC) to patients undergoing moderate sedation for endoscopy. Some patients complain of profuse rhinorrhea and⁄or sneezing after the procedure, which results in additional medical costs and patient dissatisfaction.
To determine the causal relationship between the route of oxygen delivery and troublesome nasal symptoms, and to seek possible solutions.
Patients (n=836) were randomly assigned to one of the three following groups: the NC group (n=294), the trimmed NC (TNC) group (n=268) and the nasal mask (NM) group (n=274). All received alfentanil 12.5 μg⁄kg and midazolam 0.06 mg⁄kg, and adjunct propofol for sedation. Supplemental oxygen at a flow rate of 4 L⁄min was used in the NC and TNC groups, and 6 L⁄min in the NM group. The incidence of nasal symptoms and hypoxia were assessed.
The incidence of rhinitis symptoms was significantly higher in the NC group (7.1%) than in the TNC (0.4%) and NM (0%) groups (P<0.001). The incidence of hypoxia was lower in the NC group (3.1%) (P=0.040). All hypoxia events were transient (ie, less than 30 s in duration). On spirometry, the mean value of the lowest saturation of peripheral oxygen was found to be significantly lower in the NM group (96.8%) than in the NC group (97.7%) (P=0.004).
Trimming the NC or using NMs reduced the incidence of rhinitis symptoms; however, the incidence of hypoxia was higher. Further investigation regarding the efficiency of oxygen supplementation is warranted in the design of novel oxygen delivery devices.
在内镜检查中接受中度镇静的患者通常通过鼻导管（NC）给予补充氧气。一些患者在术后抱怨有大量鼻漏和/或打喷嚏，这导致了额外的医疗费用和患者不满。
确定氧气输送途径与令人烦恼的鼻部症状之间的因果关系，并寻求可能的解决方案。
患者（n = 836）被随机分配到以下三组之一：鼻导管组（n = 294）、修剪后的鼻导管组（TNC，n = 268）和鼻面罩组（NM，n = 274）。所有患者均接受12.5μg/kg阿芬太尼和0.06mg/kg咪达唑仑，并使用丙泊酚辅助镇静。鼻导管组和修剪后的鼻导管组使用流速为4L/min的补充氧气，鼻面罩组使用流速为6L/min的补充氧气。评估鼻部症状和缺氧的发生率。
鼻导管组的鼻炎症状发生率（7.1%）显著高于修剪后的鼻导管组（0.4%）和鼻面罩组（0%）（P<0.001）。鼻导管组的缺氧发生率较低（3.1%）（P = 0.040）。所有缺氧事件均为短暂性（即持续时间少于30秒）。在肺功能测定中，发现鼻面罩组的外周血氧最低饱和度平均值（96.8%）显著低于鼻导管组（97.7%）（P = 0.004）。
修剪鼻导管或使用鼻面罩可降低鼻炎症状的发生率；然而，缺氧的发生率较高。在新型氧气输送装置的设计中，有必要对氧气补充效率进行进一步研究。
