Pereira S, Hussaini S H, Hanson P J, Wilkinson M L, Sladen G E
Division of Medicine, UMDS of Guy's Hospital, London.
J R Coll Physicians Lond. 1994 Sep-Oct;28(5):411-4.
Anxious patients tolerate endoscopy poorly. It was proposed that such patients might derive most benefit from sedation, while most non-anxious patients would prefer endoscopy with lignocaine throat spray alone. In a prospective study, 200 outpatients underwent diagnostic endoscopy after receiving one of two detailed information sheets which offered them either the choice between spray or sedation (n = 100) or the same choice but encouraged those who were anxious about endoscopy to choose sedation (n = 100). When given an informed choice, most non-anxious patients prefer not to be sedated most non-anxious patients prefer not to be sedated during diagnostic endoscopy. If patients who are anxious about the procedure are advised to choose sedation, those who nevertheless opt for topical throat spray alone find the endoscopy just as comfortable. If the endoscopy were to be repeated, 73% of the spray group and 77% of the sedation group would make the same choice again. Of 33 patients who chose spray but had been given only sedation for a previous endoscopy, 26 (79%) would choose spray again for a future endoscopy. The choice of spray or sedation should reflect the patient's view as well as that of the endoscopist.
焦虑的患者对内镜检查的耐受性较差。有人提出，这类患者可能从镇静中获益最大，而大多数不焦虑的患者更喜欢仅使用利多卡因咽喉喷雾进行内镜检查。在一项前瞻性研究中，200名门诊患者在收到两份详细信息表之一后接受了诊断性内镜检查，这两份信息表为他们提供了喷雾或镇静之间的选择（n = 100），或者相同的选择，但鼓励那些对内镜检查感到焦虑的患者选择镇静（n = 100）。当给予知情选择时，大多数不焦虑的患者在诊断性内镜检查期间更喜欢不进行镇静。如果建议对该检查感到焦虑的患者选择镇静，那些仍然选择仅使用局部咽喉喷雾的患者会觉得内镜检查同样舒适。如果内镜检查要重复进行，喷雾组的73%和镇静组的77%会再次做出相同的选择。在33名选择喷雾但之前内镜检查仅接受了镇静的患者中，26名（79%）会在未来的内镜检查中再次选择喷雾。喷雾或镇静的选择应反映患者以及内镜医师的观点。
