Shaha Sneha, Gao Yinglin, Peng Jiahao, Che Kendrick, Kim John J, Skef Wasseem
Department of Medicine, Loma Linda University Medical Center, Loma Linda, CA, USA.
Division of Gastroenterology and Hepatology, Loma Linda University Medical Center, Loma Linda, CA, USA.
Clin Endosc. 2023 Sep;56(5):658-665. doi: 10.5946/ce.2023.006. Epub 2023 Jul 3.
BACKGROUND/AIMS: We aimed to study the effects of sedation on endoscopic ultrasound-guided tissue acquisition.
We conducted a retrospective study evaluating the role of sedation in endoscopic ultrasound-guided tissue acquisition by comparing two groups: anesthesia care provider (ACP) sedation and endoscopist-directed conscious sedation (CS).
Technical success was achieved in 219/233 (94.0%) in the ACP group and 114/136 (83.8%) in the CS group (p=0.0086). In multivariate analysis, the difference in technical success between the two groups was not significant (adjusted odds ratio [aOR], 0.5; 95% confidence interval [CI], 0.234-1.069; p=0.0738). A successful diagnostic yield was present in 146/196 (74.5%) in the ACP group and 66/106 (62.3%) in the CS group, respectively (p=0.0274). In multivariate analysis, the difference in diagnostic yield between the two groups was not significant (aOR, 0.643; 95% CI, 0.356-1.159; p=0.142). A total of 33 adverse events (AEs) were observed. The incidence of AEs was significantly lower in the CS group (5/33 CS vs. 28/33 ACP; OR, 0.281; 95% CI, 0.095-0.833; p=0.022).
CS provided equivalent technical success and diagnostic yield for malignancy in endoscopic ultrasound-guided tissue acquisition. Increased AEs were associated with anesthesia for the endoscopic ultrasound-guided tissue acquisition.
背景/目的：我们旨在研究镇静对内镜超声引导下组织获取的影响。
我们进行了一项回顾性研究，通过比较两组来评估镇静在内镜超声引导下组织获取中的作用：麻醉护理人员（ACP）镇静组和内镜医师指导的清醒镇静（CS）组。
ACP组233例中有219例（94.0%）技术成功，CS组136例中有114例（83.8%）技术成功（p = 0.0086）。多因素分析显示，两组技术成功率的差异无统计学意义（调整优势比[aOR]为0.5；95%置信区间[CI]为0.234 - 1.069；p = 0.0738）。ACP组196例中有146例（74.5%）诊断成功，CS组106例中有66例（62.3%）诊断成功（p = 0.0274）。多因素分析显示，两组诊断成功率的差异无统计学意义（aOR为0.643；95%CI为0.356 - 1.159；p = 0.142）。共观察到33例不良事件（AE）。CS组的AE发生率显著更低（CS组5/33例 vs. ACP组28/33例；OR为0.281；95%CI为0.095 - 0.833；p = 0.022）。
在进行内镜超声引导下组织获取时，CS在恶性肿瘤诊断方面的技术成功率和诊断成功率相当。内镜超声引导下组织获取时增加的不良事件与麻醉相关。
