比较创新的内镜口咽气道和常规口垫在镇静下接受食管胃十二指肠镜检查的老年门诊患者中的应用：一项前瞻性随机研究。
Comparison of the innovative endoscopic oropharyngeal airway and the conventional mouthpiece in elderly outpatients undergoing esophagogastroduodenoscopy under sedation: a prospective and randomized study.
机构信息
Department of Anesthesiology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, No. 17, Lujiang Road, Luyang District, Hefei, 230001, Anhui, China.
Department of Anesthesiology, The People's Hospital of Sixian County, No. 120, Huayuan Road, Sicheng Town, Suzhou, 234300, Anhui, China.
出版信息
BMC Gastroenterol. 2022 Jan 6;22(1):8. doi: 10.1186/s12876-021-02089-6.
BACKGROUND
Undesirable outcomes may appear for elderly patients undergoing esophagogastroduodenoscopy (EGD) under sedation, such as hypoxia and hypotension. The aim of our study was to investigate the ability of the innovative endoscopic oropharyngeal airway to reduce the frequency of hypoxia during EGD under sedation in elderly patients.
METHODS
In this trial, aged patients undergoing EGD were randomized into airway group and mouthpiece group. The primary outcome was the incidence of the minimum pulse oxygen saturation < 90% and minimum pulse oxygen saturation. In addition, sedation dose, recovery time, emergency management and adverse reactions were recorded.
RESULTS
360 patients completed the study (180 in each groups). The minimum pulse oxygen saturation during EGD was significantly higher in airway group (97.66 ± 2.96%) than in mouthpiece group (95.52 ± 3.84%, P < 0.001). The incidence of pulse oxygen saturation of 85-89% of airway group (5.0%, 9/180) was lower than mouthpiece group (10.6%, 19/180, P = 0.049). The endoscopy entry time in airway group was 3 (2, 4) seconds and in mouthpiece group was 5 (4, 6) (P < 0.001). Propofol total dose and awakening time were significantly lower in the airway group than in the mouthpiece group (P = 0.020 and P = 0.012, respectively). Furthermore, the incidence rate of hypotension was significantly higher in mouthpiece group (12.2%) than in airway group (5.0%) (P = 0.015). By comparison with the mouthpiece group, the satisfaction of endoscopists was higher in airway group (P = 0.012).
CONCLUSION
Elderly patients undergoing EGD, Endoscopy Protector was associated with a significantly lower incidence of hypoxia, shortened endoscopy entry time and more stable hemodynamics.
TRIAL REGISTRATION
ChiCTR, ChiCTR2000031998, 17/04/2020. http://www.chictr.org.cn/index.aspx.
背景
接受镇静下食管胃十二指肠镜检查（EGD）的老年患者可能会出现不良后果，如缺氧和低血压。我们的研究目的是探讨创新的内镜口咽气道在减少老年患者镇静下 EGD 过程中缺氧发生率的能力。
方法
在这项试验中，接受 EGD 的老年患者被随机分为气道组和口垫组。主要结局是最低脉搏血氧饱和度<90%和最低脉搏血氧饱和度的发生率。此外，还记录了镇静剂剂量、恢复时间、紧急处理和不良反应。
结果
360 名患者完成了研究（每组 180 名）。气道组 EGD 期间的最低脉搏血氧饱和度（97.66±2.96%）明显高于口垫组（95.52±3.84%，P<0.001）。气道组 85-89%脉搏血氧饱和度的发生率（5.0%，19/180）低于口垫组（10.6%，19/180，P=0.049）。气道组的内镜进入时间为 3（2，4）秒，口垫组为 5（4，6）（P<0.001）。气道组的异丙酚总剂量和苏醒时间明显低于口垫组（P=0.020 和 P=0.012）。此外，口垫组低血压的发生率（12.2%）明显高于气道组（5.0%）（P=0.015）。与口垫组相比，气道组内镜医师的满意度更高（P=0.012）。
结论
接受 EGD 的老年患者，内镜保护器与缺氧发生率显著降低、内镜进入时间缩短和血流动力学更稳定有关。
试验注册
ChiCTR，ChiCTR2000031998，2020 年 4 月 17 日。http://www.chictr.org.cn/index.aspx。
Zotero 插件