Kiriyama Shinsuke, Naitoh Hiroshi, Fukuchi Minoru, Fukasawa Takaharu, Saito Kana, Tabe Yuichi, Yamauchi Hayato, Yoshida Tomonori, Kuwano Hiroyuki
Department of Surgery, Gunma Chuo General Hospital, 1-7-13 Koun-cho, Maebashi, Gunma 371-0025, Japan.
Department of General Surgical Science, Graduate School of Medicine, Gunma University, 3-39-22, Showa-machi, Maebashi, Gunma 371-8511, Japan.
Diagn Ther Endosc. 2014;2014:248097. doi: 10.1155/2014/248097. Epub 2014 Mar 3.
This study aimed to assess pharyngeal function between no bolus and bolus propofol induced sedation during gastric endoscopic submucosal dissection. A retrospective study was conducted involving consecutive gastric cancer patients. Patients in the no bolus group received a 3 mg/kg/h maintenance dose of propofol after the initiation of sedation without bolus injection. All patients in the bolus group received the same maintenance dose of propofol with bolus 0.5 mg/kg propofol injection. Pharyngeal functions were evaluated endoscopically for the first 5 min following the initial administration of propofol. Fourteen patients received no bolus propofol induction and 13 received bolus propofol induction. Motionless vocal cords were observed in 2 patients (14%) in the no bolus group and 3 (23%) in the bolus group. Trachea cartilage was not observed in the no bolus group but was apparent in 6 patients (46%) in the bolus group (P < 0.01). Scope stimulated pharyngeal reflex was observed in 11 patients (79%) in the no bolus group and in 3 (23%) in the bolus group (P < 0.01). Propofol induced sedation without bolus administration preserves pharyngeal function and may constitute a safer sedation method than with bolus.
本研究旨在评估在胃内镜黏膜下剥离术中,非推注丙泊酚诱导镇静与推注丙泊酚诱导镇静之间的咽部功能。对连续的胃癌患者进行了一项回顾性研究。非推注组患者在镇静开始后接受3mg/kg/h的丙泊酚维持剂量,不进行推注注射。推注组的所有患者接受相同的丙泊酚维持剂量,并推注0.5mg/kg丙泊酚。在首次给予丙泊酚后的前5分钟内,通过内镜评估咽部功能。14例患者接受非推注丙泊酚诱导,13例接受推注丙泊酚诱导。非推注组2例患者(14%)观察到声带静止,推注组3例患者(23%)观察到声带静止。非推注组未观察到气管软骨,但推注组6例患者(46%)观察到气管软骨明显(P<0.01)。非推注组11例患者(79%)观察到内镜刺激咽部反射,推注组3例患者(23%)观察到内镜刺激咽部反射(P<0.01)。非推注给药的丙泊酚诱导镇静可保留咽部功能,可能比推注给药构成更安全的镇静方法。