From the Department of Medicine, KRH Klinikum Agnes Karll, Laatzen (AR, MS, CK, CM, VL, CU), Department of Anesthesiology, Hannover Medical School, Hannover, Germany (BS), Department of Mathematics, University of Bergen, Bergen, Norway (JB)*Both authors contributed equally to the study.
Eur J Anaesthesiol. 2017 Oct;34(10):681-687. doi: 10.1097/EJA.0000000000000665.
Sedation for colonoscopy using intravenous propofol has become standard in many Western countries.
Gender-specific differences have been shown for general anaesthesia in dentistry, but no such data existed for gastrointestinal endoscopy.
A prospective observational study.
An academic teaching hospital of Hannover Medical School.
A total of 219 patients (108 women and 111 men) scheduled for colonoscopy.
Propofol sedation using electroencephalogram monitoring during a constant level of sedation depth (D0 to D2) performed by trained nurses or physicians after a body-weight-adjusted loading dose.
The primary end-point was the presence of gender-specific differences in awakening time (time from end of sedation to eye-opening and complete orientation); secondary outcome parameters analysed were total dose of propofol, sedation-associated complications (bradycardia, hypotension, hypoxaemia and apnoea), patient cooperation and patient satisfaction. Multivariate analysis was performed to correct confounding factors such as age and BMI.
Women awakened significantly faster than men, with a time to eye-opening of 7.3 ± 3.7 versus 8.4 ± 3.4 min (P = 0.005) and time until complete orientation of 9.1 ± 3.9 versus 10.4 ± 13.7 min (P = 0.008). The propofol dosage was not significantly different, with some trend towards more propofol per kg body weight in women (3.98 ± 1.81 mg versus 3.72 ± 1.75 mg, P = 0.232).
The effect of gender aspects should be considered when propofol is used as sedation for gastrointestinal endoscopy. That includes adequate dosing for women as well as caution regarding potential overdosing of male patients.
ClinicalTrials.gov (Identifier: NCT02687568).
在许多西方国家，静脉注射异丙酚镇静已成为结肠镜检查的标准。
在牙科领域，全麻已经显示出性别特异性差异，但在胃肠内镜检查中尚无此类数据。
前瞻性观察性研究。
汉诺威医学院的一所学术教学医院。
共 219 名患者（108 名女性和 111 名男性），计划行结肠镜检查。
在由经过培训的护士或医生在体重调整后的负荷剂量后，使用脑电图监测，在恒定的镇静深度（D0 至 D2）下进行异丙酚镇静。
主要终点是苏醒时间（镇静结束至睁眼和完全定向之间的时间）是否存在性别特异性差异；分析的次要结局参数是异丙酚总剂量、镇静相关并发症（心动过缓、低血压、低氧血症和呼吸暂停）、患者合作和患者满意度。进行多变量分析以校正年龄和 BMI 等混杂因素。
女性苏醒时间明显快于男性，睁眼时间为 7.3±3.7 分钟对 8.4±3.4 分钟（P=0.005），完全定向时间为 9.1±3.9 分钟对 10.4±13.7 分钟（P=0.008）。异丙酚剂量无显著差异，女性每公斤体重异丙酚用量略有增加（3.98±1.81mg 对 3.72±1.75mg，P=0.232）。
在胃肠内镜检查中使用异丙酚镇静时，应考虑性别因素的影响。这包括为女性提供足够的剂量，并谨慎对待男性患者潜在的过量用药。
ClinicalTrials.gov（标识符：NCT02687568）。
