Lavies N G, Creasy T, Harris K, Hanning C D
Department of Anesthesia, Leicester General Hospital, England.
Am J Gastroenterol. 1988 Jun;83(6):618-22.
In order to compare the effects of Diazemuls and midazolam on arterial oxygen saturation during upper gastrointestinal endoscopy, 120 patients were randomly allocated to receive Diazemuls, midazolam, or normal saline. Endoscopy was performed by one consultant or one of four residents. Arterial oxygen saturation was monitored continuously during endoscopy by means of a Biox III pulse oximeter and ear probe. Oxygen saturation fell during endoscopy in all three groups, but no significant differences between the groups were detected at any stage of the procedure. When all groups were combined, there was significantly less desaturation when the consultant performed the endoscopy, and he was also significantly faster in carrying out endoscopy than the residents in each group. When an inexperienced resident was compared with one with at least 6 months of experience, there were significant differences in degree of desaturation, lowest value during endoscopy and tolerance score. It is suggested that the patient at risk of hypoxemia should, if possible, be endoscoped by an experienced endoscopist.
为比较脂肪乳剂和咪达唑仑在上消化道内镜检查期间对动脉血氧饱和度的影响，将120例患者随机分为三组，分别接受脂肪乳剂、咪达唑仑或生理盐水。内镜检查由一名顾问医师或四名住院医师之一进行。在内镜检查期间，通过Biox III脉搏血氧仪和耳部探头持续监测动脉血氧饱和度。三组患者在内镜检查期间血氧饱和度均下降，但在操作的任何阶段，各组之间均未检测到显著差异。当将所有组合并时，由顾问医师进行内镜检查时，血氧饱和度下降明显较少，并且他进行内镜检查的速度也明显快于每组中的住院医师。当将经验不足的住院医师与至少有6个月经验的住院医师进行比较时，在血氧饱和度下降程度、内镜检查期间的最低值和耐受评分方面存在显著差异。建议有低氧血症风险的患者，如有可能，应由经验丰富的内镜医师进行内镜检查。
