Rigg J D, Watt T C, Tweedle D E, Martin D F
Department of Anaesthetics, Withington Hospital, Manchester.
Gut. 1994 Mar;35(3):408-11. doi: 10.1136/gut.35.3.408.
Patients having endoscopic retrograde cholangiopancreatography (ERCP) are generally elderly and require sedation while in the prone position. These factors may be expected to aggravate any risk of arterial hypoxia. This study evaluated two protocols of oxygen administration, one with and one without pre-oxygenation. In 25 patients in whom pre-oxygenation with 4 litres/minute for five minutes before sedation was used, followed by continuous oxygen administration, arterial oxygen saturation did not fall below 90% at any stage during the procedure. By contrast, in 25 patients who were not pre-oxygenated oxygen saturation fell below 90% in nine (36%). As expected, hypoxia occurred most frequently during the early stages of sedation and endoscope insertion. Hypoxia did not occur in association with operations such as sphincterotomy, stone extraction or stent insertion. This study confirms that arterial hypoxia is a common event during ERCP and can be completely prevented by pre-oxygenation with four litres of oxygen given intranasally for five minutes before sedation.
接受内镜逆行胰胆管造影（ERCP）的患者通常年事已高，且在俯卧位时需要镇静。这些因素可能会增加动脉血氧不足的风险。本研究评估了两种输氧方案，一种是预充氧，另一种则没有预充氧。25例患者在镇静前以每分钟4升的流量预充氧5分钟，随后持续输氧，术中任何阶段动脉血氧饱和度均未降至90%以下。相比之下，25例未进行预充氧的患者中，有9例（36%）的血氧饱和度降至90%以下。正如预期的那样，低氧血症最常发生在镇静和插入内镜的早期阶段。低氧血症与诸如括约肌切开术、取石术或支架置入术等操作无关。本研究证实，动脉血氧不足是ERCP过程中的常见情况，在镇静前通过鼻内给予4升氧气预充氧5分钟可完全预防。
