Chen Yongpeng, Sun Jiachen, Lu Yi, Fu Liping, Xiang Xueyuan, Liu Yanan, Zhuo Xianhua, Kurban Mirigul, Li Chujun
Department of Gastrointestinal Endoscopy, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China.
Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China.
Front Pharmacol. 2022 Nov 3;13:945597. doi: 10.3389/fphar.2022.945597. eCollection 2022.
Digestive endoscopy is an important means of diagnosing and treating gastrointestinal diseases and a tool for screening and monitoring early gastrointestinal tumors. Digestive endoscopy can be performed using midazolam combined with dezocine for sedation and analgesia. This study explored the efficacy and safety of midazolam combined with dezocine. A total of 135 patients undergoing digestive endoscopy in the Department of Gastrointestinal Endoscopy of the Sixth Affiliated Hospital, Sun Yat-sen University, from June 2021 to September 2021, were enrolled and non-blindly and non-randomly divided into a sedation-endoscopy-group (SEG, = 45), anesthesia-endoscopy-group (AEG, = 44), and ordinary-endoscopy-group (OEG, = 46). Vital signs, levels of sedation and analgesia, the degree of pain during colonoscopy, satisfaction, and the incidence of complications were compared among the three groups. There were no statistically significant differences in vital signs (blood pressure, pulse, respiration, and blood oxygen saturation) among the three groups before endoscopy ( 0.05). The AEG reported no pain during colonoscopy, and the pain score during colonoscopy for the SEG was lower than that for the OEG (1.11 ± 1.21 . 3.00 ± 1.16, 0.001). The scores for satisfaction were 8.84 ± 1.30 points in the SEG, 8.95 ± 1.10 points in the AEG, and 6.37 ± 0.90 points in the OEG; the differences were statistically significant ( 0.001). The total incidence of complications in the AEG was 38.64% (17/44), which was significantly higher than that in the SEG [13.33% (6/45)] and OEG [13.04% (6/46)] ( 0.001). In the SEG, the overall incidence of complications in women was significantly higher than that in men ( 0.027). Digestive endoscopy using midazolam combined with dezocine for sedation makes patients more comfortable, more satisfied and more compliant than the ordinary endoscopy. Additionally, it is comparable to endoscopy under general anesthesia with propofol with regard to comfort, satisfaction, and patient compliance and comparable to the ordinary endoscopy with regard to safety. Considering the shortage of anesthesiologists, the application of midazolam combined with dezocine in digestive endoscopy is worthy of clinical popularization. This study has been registered in the Hospital Ethics Committee of the Sun Yat-sen University Sixth Affiliated Hospital (Ethical Number: 2021ZSLYEC-182).
消化内镜检查是诊断和治疗胃肠道疾病的重要手段,也是筛查和监测早期胃肠道肿瘤的工具。消化内镜检查可使用咪达唑仑联合地佐辛进行镇静和镇痛。本研究探讨了咪达唑仑联合地佐辛的有效性和安全性。选取2021年6月至2021年9月在中山大学附属第六医院胃肠内镜科接受消化内镜检查的135例患者,进行非盲非随机分组,分为镇静内镜组(SEG,n = 45)、麻醉内镜组(AEG,n = 44)和普通内镜组(OEG,n = 46)。比较三组患者的生命体征、镇静和镇痛水平、结肠镜检查时的疼痛程度、满意度及并发症发生率。内镜检查前,三组患者的生命体征(血压、脉搏、呼吸和血氧饱和度)差异无统计学意义(P > 0.05)。AEG组在结肠镜检查过程中无疼痛,SEG组结肠镜检查时的疼痛评分低于OEG组(1.11±1.21 vs. 3.00±1.16,P < 0.001)。SEG组的满意度评分为8.84±1.30分,AEG组为8.95±1.10分,OEG组为6.37±0.90分;差异有统计学意义(P < 0.001)。AEG组并发症总发生率为38.64%(17/44),显著高于SEG组[13.33%(6/45)]和OEG组[13.04%(6/46)](P < 0.001)。在SEG组中,女性并发症的总体发生率显著高于男性(P < 0.027)。使用咪达唑仑联合地佐辛进行镇静的消化内镜检查比普通内镜检查让患者更舒适、更满意且更配合。此外,在舒适度、满意度和患者配合度方面,它与丙泊酚全身麻醉下的内镜检查相当,在安全性方面与普通内镜检查相当。考虑到麻醉医生短缺的情况,咪达唑仑联合地佐辛在消化内镜检查中的应用值得临床推广。本研究已在中山大学附属第六医院医院伦理委员会注册(伦理编号:2021ZSLYEC - 182)。