诊断性食管胃十二指肠镜检查在阻塞性睡眠呼吸暂停患者中镇静的风险。
Risk of sedation for diagnostic esophagogastroduodenoscopy in obstructive sleep apnea patients.
机构信息
Department of Internal Medicine, Kyung Hee University Hospital at Gang Dong, Seoul 134-727, South Korea.
出版信息
World J Gastroenterol. 2013 Aug 7;19(29):4745-51. doi: 10.3748/wjg.v19.i29.4745.
AIM
To investigate whether patients with obstructive sleep apnea (OSA) are at risk of sedation-related complications during diagnostic esophagogastroduodenoscopy (EGD).
METHODS
A prospective study was performed in consecutive patients with OSA, who were confirmed with full-night polysomnography between July 2010 and April 2011. The occurrence of cardiopulmonary complications related to sedation during diagnostic EGD was compared between OSA and control groups.
RESULTS
During the study period, 31 patients with OSA and 65 controls were enrolled. Compared with the control group, a higher dosage of midazolam was administered (P = 0.000) and a higher proportion of deep sedation was performed (P = 0.024) in the OSA group. However, all adverse events, including sedation failure, paradoxical responses, snoring or apnea, hypoxia, hypotension, oxygen or flumazenil administration, and other adverse events were not different between the two groups (all P > 0.1). Patients with OSA were not predisposed to hypoxia with multivariate logistic regression analysis (P = 0.068).
CONCLUSION
In patients with OSA, this limited sized study did not disclose an increased risk of cardiopulmonary complications during diagnostic EGD under sedation.
目的
研究阻塞性睡眠呼吸暂停（OSA）患者在诊断性食管胃十二指肠镜检查（EGD）期间是否存在镇静相关并发症的风险。
方法
这是一项前瞻性研究，纳入了 2010 年 7 月至 2011 年 4 月期间经整夜多导睡眠图（PSG）确诊的 OSA 连续患者。比较 OSA 组和对照组在诊断性 EGD 镇静期间与镇静相关的心肺并发症的发生情况。
结果
在研究期间，纳入了 31 例 OSA 患者和 65 例对照患者。与对照组相比，OSA 组中咪达唑仑的剂量更高（P = 0.000），深度镇静的比例更高（P = 0.024）。然而，两组之间所有不良事件，包括镇静失败、矛盾反应、打鼾或呼吸暂停、缺氧、低血压、氧或氟马西尼的应用以及其他不良事件均无差异（均 P > 0.1）。多变量逻辑回归分析显示，OSA 患者并未增加缺氧的风险（P = 0.068）。
结论
在 OSA 患者中，这项有限规模的研究并未揭示在镇静下进行诊断性 EGD 期间心肺并发症风险增加。
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