Ball Alex J, Din Said, Donnelly Mark, Riley Stuart A
aDepartment of Gastroenterology, Northern General Hospital bSouth Yorkshire and Bassetlaw Bowel Cancer Screening Centre, Sheffield Teaching Hospitals cDepartment of Oncology, University of Sheffield, Medical School, Sheffield, UK.
Eur J Gastroenterol Hepatol. 2015 Mar;27(3):271-8. doi: 10.1097/MEG.0000000000000281.
Entonox is a 50 : 50 combination of nitrous oxide and oxygen, which may be used to manage pain during colonoscopy. The optimal mode of Entonox administration is unknown. The aim of this study was therefore to compare continuous and as-required Entonox use.
Patients attending for screening colonoscopy at a single centre were randomized to continuous or as-required Entonox use. The primary outcome measure was the patient's overall pain rating at the time of discharge (verbally administered numerical ratings scale, 0=no pain and 10=extreme pain). Secondary outcome measures included the patients' experience of pain during the colonoscopy (rated every 2 min), side effects and the need for rescue intravenous medications.
A total of 108 patients were randomized, and 100 completed the study (46 continuous, 54 as required). The overall pain scores at discharge did not differ between those who used Entonox continuously and as required (mean=2.4 vs. 3.2, P=0.08). There were also no differences in the experience of pain during colonoscopy (mean=1.8 vs. 2.2, P=0.28; peak=4.2 vs. 4.8, P=0.26; and area under curve=23 vs. 30, P=0.24). Patients with high anxiety had greater overall pain scores (mean=3.7 vs. 2.4, P=0.03). Light headedness occurred more often with continuous Entonox use (48 vs. 21%, P=0.009).
Among patients attending for screening colonoscopy, comfort ratings were similar in those using Entonox continuously and as required, but light headedness was more common with continuous use (NCT identifier: 01865721).
恩托诺克斯是一氧化二氮和氧气按50∶50混合而成的气体，可用于结肠镜检查期间的疼痛管理。恩托诺克斯的最佳给药方式尚不清楚。因此，本研究旨在比较持续使用和按需使用恩托诺克斯的效果。
在单一中心接受筛查结肠镜检查的患者被随机分为持续使用或按需使用恩托诺克斯两组。主要结局指标为出院时患者的总体疼痛评分（采用口头数字评分量表，0分=无疼痛，10分=剧痛）。次要结局指标包括患者在结肠镜检查期间的疼痛体验（每2分钟评分一次）、副作用以及使用急救静脉药物的必要性。
共有108例患者被随机分组，100例完成研究（持续使用组46例，按需使用组54例）。持续使用和按需使用恩托诺克斯的患者出院时总体疼痛评分无差异（均值分别为2.4和3.2，P=0.08）。结肠镜检查期间的疼痛体验也无差异（均值分别为1.8和2.2，P=0.28；峰值分别为4.2和4.8，P=0.26；曲线下面积分别为23和30，P=0.24）。焦虑程度高的患者总体疼痛评分更高（均值分别为3.7和2.4，P=0.03）。持续使用恩托诺克斯时头晕的发生率更高（48%对21%，P=0.009）。
在接受筛查结肠镜检查的患者中，持续使用和按需使用恩托诺克斯的舒适度评分相似，但持续使用时头晕更为常见（NCT标识符：01865721）。
