Kayaaltı Selda, Kayaaltı Ömer
Division of Anaesthesiology and Reanimation, Develi Public Hospital, Develi, Kayseri 38400, Turkey.
Computer Technology, Kayseri University, Develi Huseyin Sahin Vocational College, Develi, Kayseri 38400, Turkey.
World J Clin Cases. 2018 Dec 26;6(16):1146-1154. doi: 10.12998/wjcc.v6.i16.1146.
To compare the results of midazolam-ketamine-propofol sedation performed by an endoscopy nurse and anaesthetist during colonoscopy in terms of patient satisfaction and safety.
American Statistical Association (ASA) I-II 60 patients who underwent colonoscopy under sedation were randomly divided into two groups: sedation under the supervision of an anaesthetist (SSA) and sedation under the supervision of an endoscopy nurse (SSEN). Both groups were initially administered 1 mg midazolam, 50 mg ketamine and 30-50 mg propofol. Continuation of sedation was performed by the anaesthetist in the SSA group and the nurse with a patient-controlled analgesia (PCA) pump in the SSEN group. The total propofol consumption, procedure duration, recovery times, pain using the visual analogue scale (VAS) and satisfaction score of the patients, and side effects were recorded. In addition, the patients were asked whether they remembered the procedure and whether they would prefer the same method in the case of re-endoscopy.
Total propofol consumption in the SSEN group was significantly higher (P < 0.05) than that in the SSA group. When the groups were compared in terms of VAS score, recovery time, patient satisfaction, recall of the procedure, re-preference for the same method in case of re-endoscopy, and side effects, there were no significant differences (P > 0.05) between the two groups. No long-term required intervention side effects were observed in either group.
Colonoscopy sedation in ASA I-II patients can be safely performed by an endoscopy nurse using PCA pump with the incidence of side effects and patient satisfaction levels similar to sedation under anaesthetist supervision.
比较在内镜检查护士和麻醉医生实施的咪达唑仑 - 氯胺酮 - 丙泊酚镇静下进行结肠镜检查的效果，评估患者满意度和安全性。
将60例接受镇静下结肠镜检查的美国麻醉医师协会（ASA）I - II级患者随机分为两组：麻醉医生监督下的镇静组（SSA）和内镜检查护士监督下的镇静组（SSEN）。两组均先给予1 mg咪达唑仑、50 mg氯胺酮和30 - 50 mg丙泊酚。SSA组由麻醉医生持续给予镇静，SSEN组由护士使用患者自控镇痛（PCA）泵持续给予镇静。记录丙泊酚总用量、操作时间、恢复时间、采用视觉模拟评分法（VAS）评估的疼痛程度、患者满意度评分及副作用。此外，询问患者是否记得操作过程以及再次进行内镜检查时是否会选择相同的方法。
SSEN组丙泊酚总用量显著高于SSA组（P < 0.05）。两组在VAS评分、恢复时间、患者满意度、操作记忆、再次内镜检查时对相同方法的偏好以及副作用方面比较，差异无统计学意义（P > 0.05）。两组均未观察到需要长期干预治疗的副作用。
对于ASA I - II级患者，内镜检查护士使用PCA泵可安全地实施结肠镜检查镇静，副作用发生率和患者满意度与麻醉医生监督下的镇静相似。
