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丙泊酚与咪达唑仑用于儿童食管胃十二指肠镜检查镇静的比较。

Propofol versus Midazolam for Sedation during Esophagogastroduodenoscopy in Children.

作者信息

Oh Ji Eun, Lee Hae Jeong, Lee Young Hwan

机构信息

Department of Internal Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea.

出版信息

Clin Endosc. 2013 Jul;46(4):368-72. doi: 10.5946/ce.2013.46.4.368. Epub 2013 Jul 31.

Abstract

BACKGROUND/AIMS: To evaluate the efficacy and safety of propofol and midazolam for sedation during esophagogastroduodenoscopy (EGD) in children.

METHODS

We retrospectively reviewed the hospital records of 62 children who underwent ambulatory diagnostic EGD during 1-year period. Data were collected from 34 consecutive patients receiving propofol alone. Twenty-eight consecutive patients who received sedation with midazolam served as a comparison group. Outcome variables were length of procedure, time to recovery and need for additional supportive measures.

RESULTS

There were no statistically significant differences between the two groups in age, weight, sex, and the length of endoscopic procedure. The recovery time from sedation was markedly shorter in propofol group (30±16.41 minutes) compared with midazolam group (58.89±17.32 minutes; p<0.0001). During and after the procedure the mean heart rate was increased in midazolam group (133.04±19.92 and 97.82±16.7) compared with propofol group (110.26±20.14 and 83.26±12.33; p<0.0001). There was no localized pain during sedative administration in midazolam group, though six patients had localized pain during administration of propofol (p<0.028). There was no serious major complication associated with any of the 62 procedures.

CONCLUSIONS

Intravenous administered propofol provides faster recovery time and similarly safe sedation compared with midazolam in pediatric patients undergoing upper gastrointestinal endoscopy.

摘要

背景/目的:评估丙泊酚和咪达唑仑在儿童食管胃十二指肠镜检查(EGD)期间镇静的有效性和安全性。

方法

我们回顾性分析了62例在1年期间接受门诊诊断性EGD的儿童的医院记录。数据收集自34例连续仅接受丙泊酚治疗的患者。28例连续接受咪达唑仑镇静的患者作为对照组。观察指标包括操作时间、恢复时间以及是否需要额外的支持措施。

结果

两组在年龄、体重、性别和内镜操作时间方面无统计学显著差异。丙泊酚组的镇静恢复时间(30±16.41分钟)明显短于咪达唑仑组(58.89±17.32分钟;p<0.0001)。在操作期间和操作后,咪达唑仑组的平均心率升高(分别为133.04±19.92和97.82±16.7),而丙泊酚组为(110.26±20.14和83.26±12.33;p<0.0001)。咪达唑仑组在镇静给药期间无局部疼痛,而丙泊酚给药期间有6例患者出现局部疼痛(p<0.028)。62例操作中均未出现严重的主要并发症。

结论

在接受上消化道内镜检查的儿科患者中,静脉注射丙泊酚与咪达唑仑相比,恢复时间更快,镇静安全性相似。

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本文引用的文献

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Safe and effective procedural sedation for gastrointestinal endoscopy in children.儿童胃肠内镜检查的安全有效镇静。
J Pediatr Gastroenterol Nutr. 2012 Feb;54(2):171-85. doi: 10.1097/MPG.0b013e31823a2985.
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Endoscopist-directed administration of propofol: a worldwide safety experience.内镜医师指导下丙泊酚的给药:全球安全性经验
Gastroenterology. 2009 Oct;137(4):1229-37; quiz 1518-9. doi: 10.1053/j.gastro.2009.06.042. Epub 2009 Jun 21.
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Endoscopic sedation in pediatric practice.儿科内镜检查中的镇静
Gastrointest Endosc Clin N Am. 2008 Oct;18(4):739-51, ix. doi: 10.1016/j.giec.2008.06.006.

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