Lee Seung Hwa, Lee Gyu Min, Lee Dong Ryul, Lee Jung Un
a Center for Health Promotion and Endoscopy, Seohae Hospital , Seocheon , South Korea.
b Center for Health Promotion and Endoscopy, Wonkwang University School of Medicine , Gunpo , South Korea.
Scand J Gastroenterol. 2019 Mar;54(3):371-376. doi: 10.1080/00365521.2019.1585938. Epub 2019 Mar 31.
The factors related to paradoxical excitement during propofol-induced sedation remain unclear. We aimed to investigate this issue during sedated upper endoscopy. Among the health examinees scheduled for sedated upper endoscopy from June 2017 to December 2017, 421 participated in the study. Endoscopists were blinded to the information about the examinees and evaluated the development of paradoxical reactions. Propofol was exclusively used as the sedative agent via intermittent bolus injection. A multiple logistic regression analysis was performed to investigate the factors associated with paradoxical reactions. The incidence of paradoxical reactions was 16.1%. Anxiety (adjusted odds ratio: 2.76; 95% confidence interval: 1.46 - 5.27; = .002) and age (odds ratio: 0.92; 95% confidence interval: 0.89 - 0.96; < .001) were significantly associated with paradoxical reactions. Of the nine items of the anxiety questionnaire, four had independent and significant associations with paradoxical reactions (i.e., excess worry, sleeping problems, somatic symptoms, and health concerns; odds ratios: 2.38, 2.71, 2.27 and 2.39, respectively). Propofol-induced paradoxical reactions tend to occur when an individual has anxiety and is of a young age. Further large population-based studies should be performed to confirm this phenomenon.
丙泊酚诱导镇静期间出现矛盾性兴奋的相关因素尚不清楚。我们旨在在内镜检查镇静期间研究这一问题。在2017年6月至2017年12月计划进行内镜检查镇静的健康体检者中，421人参与了本研究。内镜医师对体检者的信息不知情，并评估矛盾反应的发生情况。丙泊酚仅通过间歇性推注用作镇静剂。进行多因素logistic回归分析以研究与矛盾反应相关的因素。矛盾反应的发生率为16.1%。焦虑（校正比值比：2.76；95%置信区间：1.46 - 5.27；P = 0.002）和年龄（比值比：0.92；95%置信区间：0.89 - 0.96；P < 0.001）与矛盾反应显著相关。在焦虑问卷的九个项目中，有四个与矛盾反应存在独立且显著的关联（即过度担忧、睡眠问题、躯体症状和健康担忧；比值比分别为2.38、2.71、2.27和2.39）。当个体存在焦虑且年龄较小时，丙泊酚诱导的矛盾反应更容易发生。应进行进一步的大样本群体研究以证实这一现象。
