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用于高级上消化道内镜检查的无推注与推注丙泊酚诱导镇静下的咽功能评估

Evaluation of Pharyngeal Function between No Bolus and Bolus Propofol Induced Sedation for Advanced Upper Endoscopy.

作者信息

Kiriyama Shinsuke, Naitoh Hiroshi, Fukuchi Minoru, Fukasawa Takaharu, Saito Kana, Tabe Yuichi, Yamauchi Hayato, Yoshida Tomonori, Kuwano Hiroyuki

机构信息

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.

出版信息

Diagn Ther Endosc. 2014;2014:248097. doi: 10.1155/2014/248097. Epub 2014 Mar 3.

Abstract

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.

摘要

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。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d479/3958785/246648250811/DTE2014-248097.001.jpg

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