Department of Gastroenterology, Beijing Friendship Hospital, Capital Medical University, National Clinical Research Center for Digestive Disease, Beijing Digestive Disease Center, Beijing Key Laboratory for Precancerous Lesion of Digestive Disease, Beijing, 100050, China.
Psychiatry Department, Beijing Hai-Dian Hospital, Beijing, 100080, China.
BMC Anesthesiol. 2023 Jun 24;23(1):223. doi: 10.1186/s12871-023-02122-z.
Patients are recommended not to drive for at least the first 24 h after endoscopy with propofol sedation. However, the evidence underlying these recommendations is scarce. We hypothesized that after endoscopic procedures performed under propofol sedation, the subject's driving ability was restored in less than 24 h.
We prospectively enrolled thirty patients between 20 and 70 years possessing a legitimate driver's license scheduled for endoscopy at our hospital. The sample chosen was a convenience sample. Gastroscopy or colonoscopy was performed with propofol sedation. Before and after endoscopy, the investigator drove the subjects to the laboratory to assess their driving skills using a driving simulation system, which employs 3 driving scenarios designed by professional transportation researchers. The blood propofol concentration was estimated before endoscopy, and 2 and 4 h after endoscopy. The primary outcome was the time required for subjects to recover their driving ability after propofol sedation. The secondary outcome was the blood propofol concentration before and after endoscopic procedures under propofol anesthesia.
Thirty volunteers participated in the study and 18 of them completed all the interventions. In the low-risk S-curve scene, the mean acceleration, lane deviation, and number of deviations from the path at baseline (0.016 cm/s, 42.50 cm, and 0.83, respectively) were significantly less than that at post-2 h (0.029 cm/s, P = 0.001; 53.80 cm, P = 0.014; 2.06, P = 0.022). In the moderate-(overtaking) and high-risk (emergency collision avoidance) scenes, the tested parameters at baseline and post-2 h were statistically comparable. In the low-, moderate-, and high-risk scenes the tested parameters at baseline and post-4 h were statistically comparable. The total range of propofol was 120-280 mg.The mean blood concentration of propofol at post-2 h was 0.81 ± 0.40 µg/mL, and at post-4 h was below the limit of detection.
After endoscopy performed under propofol sedation, subjects' driving abilities were completely restored at 4 h when tested on a simulator.
患者在接受异丙酚镇静内镜检查后至少 24 小时内被建议不要驾车。然而，这些建议的依据很少。我们假设在接受异丙酚镇静内镜检查后，受试者的驾驶能力在 24 小时内恢复。
我们前瞻性地招募了 30 名年龄在 20 至 70 岁之间、持有合法驾照的患者，这些患者计划在我们医院接受内镜检查。选择的样本是方便样本。胃镜或结肠镜检查采用异丙酚镇静。在进行内镜检查之前和之后，研究者驾驶患者前往实验室，使用由专业交通研究人员设计的 3 种驾驶场景的驾驶模拟系统评估他们的驾驶技能。在进行内镜检查之前和之后 2 小时和 4 小时，估计血液中异丙酚的浓度。主要结局是接受异丙酚镇静后患者恢复驾驶能力所需的时间。次要结局是接受异丙酚麻醉下内镜检查前后的血液异丙酚浓度。
30 名志愿者参加了这项研究，其中 18 名志愿者完成了所有干预措施。在低风险 S 曲线场景中，平均加速度、车道偏离和偏离路径的次数（分别为 0.016cm/s、42.50cm 和 0.83）明显低于 2 小时后（0.029cm/s，P=0.001；53.80cm，P=0.014；2.06，P=0.022）。在中度（超车）和高度风险（紧急避撞）场景中，基线和 2 小时后测试的参数具有统计学可比性。在低、中、高风险场景中，基线和 4 小时后测试的参数具有统计学可比性。异丙酚的总范围为 120-280mg。2 小时后血液中异丙酚的平均浓度为 0.81±0.40μg/ml，4 小时后低于检测限。
接受异丙酚镇静内镜检查后，在模拟器上进行测试时，受试者的驾驶能力在 4 小时后完全恢复。
