Children's Medical Center, Taipei Veterans General Hospital, Taipei, Taiwan.
Pediatr Neonatol. 2012 Jun;53(3):188-92. doi: 10.1016/j.pedneo.2012.04.006. Epub 2012 Jun 5.
There is insufficient data on pediatric endoscopic sedation practices worldwide. This study aimed to assess nationwide data on the current pediatric endoscopic sedation practices in Taiwan.
Members of the Taiwan Society of Pediatric Gastroenterology Hepatology and Nutrition in 2010 were asked to participate in an 18-item questionnaire survey regarding current sedation practices for diagnostic esophagogastric-duodenoscopy (EGD).
A total of 22 of 32 questionnaires were returned for a response rate of 68.8%. A majority (86.4%) of the respondents practiced in a medical center hospital setting, and 72.7% preferred sedation during EGD. The proportions of respondents applying sedative methods in cases aged < 1, 1∼12, and > 12 years old were 85.7%, 100%, and 23.7% respectively. Ketamine (27.8%) and midazolam with meperidine (22.2%) were the most commonly applied sedation agents, while the percentage of respondents using regimens that included propofol was 11.2%. Comparing complications between EGD with and without sedation, only hypoxia (Wilcoxon statistics=347.00, p=0.003) was significantly more common in sedated patients. The endoscopists' satisfaction rating was greater among respondents using sedation compared to those without (visual analog scale 9 vs. 7; p=0.0001).
A majority of pediatric EGD in Taiwan was performed under sedation and applied more often to younger children. Endoscopists were more satisfied during EGD when practicing sedation. This survey should help formulate updated practice guidelines and policies regarding endoscopic sedation.
目前全球范围内有关儿科内镜镇静实践的数据有限。本研究旨在评估台湾全国范围内目前儿科内镜镇静实践的数据。
2010 年，邀请台湾小儿肠胃病学、肝脏病学和营养学学会成员参与一项针对诊断性食管胃十二指肠镜检查（EGD）当前镇静实践的 18 项问卷调查。
共收回 32 份问卷中的 22 份，回复率为 68.8%。大多数（86.4%）受访者在医学中心医院环境中执业，72.7%的人在 EGD 中选择镇静。在年龄<1、1∼12 和>12 岁的患者中应用镇静方法的受访者比例分别为 85.7%、100%和 23.7%。最常用的镇静剂是氯胺酮（27.8%）和咪达唑仑加哌替啶（22.2%），而使用包含丙泊酚的方案的受访者比例为 11.2%。比较镇静和非镇静 EGD 之间的并发症，只有缺氧（Wilcoxon 统计量=347.00，p=0.003）在镇静患者中更为常见。与未镇静的患者相比，使用镇静的内镜医师满意度评分更高（视觉模拟量表 9 分 vs. 7 分；p=0.0001）。
在台湾，大多数儿科 EGD 在镇静下进行，并且更常用于年龄较小的儿童。在进行镇静时，内镜医师的满意度更高。本调查应有助于制定有关内镜镇静的更新实践指南和政策。
