Department of Gastroenterology, Norwalk Hospital, 34 Stevens St. Norwalk, CT 06850, USA.
World J Gastroenterol. 2011 Sep 14;17(34):3912-5. doi: 10.3748/wjg.v17.i34.3912.
To determine if anesthesiologist-monitored use of propofol results in improved detection of adenomas when compared with routine conscious sedation.
This retrospective study was conducted at two separate hospital-based endoscopy units where approximately 12,000 endoscopic procedures are performed annually, with one endoscopy unit exclusively using anesthesiologist-monitored propofol. Three thousand two hundred and fifty-two patients underwent initial screening or surveillance colonoscopies. Our primary end point was the adenoma detection rate, defined as the number of patients in whom at least one adenoma was found, associated with the type of sedation.
Three thousand two hundred and fifty-two outpatient colonoscopies were performed by five selected endoscopists. At least one adenoma was detected in 27.6% of patients (95% CI = 26.0-29.1) with no difference in the detection rate between the anesthesiologist-propofol and group and the gastroenterologist-midazolam/fentanyl group (28.1% vs 27.1%, P = 0.53).
The type of sedation used during colonoscopy does not affect the number of patients in whom adenomatous polyps are detected.
比较麻醉师监测下使用异丙酚与常规清醒镇静时，检测腺瘤的效果。
本回顾性研究在两个独立的医院内镜中心进行，每年约进行 12000 例内镜检查，其中一个内镜中心专门使用麻醉师监测下的异丙酚。3252 例患者接受了初始筛查或监测结肠镜检查。我们的主要终点是腺瘤检出率，定义为至少检出一个腺瘤的患者数量，与镇静类型相关。
5 名选定的内镜医师共进行了 3252 例门诊结肠镜检查。27.6%（95%CI=26.0-29.1）的患者中至少检出一个腺瘤，麻醉师-异丙酚组和胃肠病学家-咪达唑仑/芬太尼组的检出率无差异（28.1%比 27.1%，P=0.53）。
结肠镜检查中使用的镇静类型不会影响腺瘤性息肉检出患者的数量。
