Kelly M C, Loan W C
Dept. of Anaesthetics, Daisy Hill Hospital, Newry, Northern Ireland, United Kingdom.
Endoscopy. 1996 Oct;28(8):689-93. doi: 10.1055/s-2007-1005578.
Recently, attention has been drawn to the significant occurrence of respiratory and other complications during upper intestinal endoscopy. This prospective study was designed to compare the incidence and severity of oxygen desaturation when two different methods of oxygen delivery were used during elective oesophagogastroduodenoscopy.
After local medical ethics committee approval and written informed consent, one hundred patients undergoing elective oesophagogastroduodenoscopy were randomly allocated to receive supplemental oxygen at either four litres per minute via nasal specular or ten litres per minute through a specially modified non-rebreathing mask. Oxygen saturations during endoscopy facilitated by midazolam sedation were recorded, and non-parametric tests were used to compare the oxygen saturations in the two groups.
The mean oxygen saturations were significantly better during the procedure for American Society of Anesthesiology (ASA) grade 2 and 3 patients who received oxygen with the modified mask than for those who received oxygen via nasal specular (98.6% vs. 97.0%, P = 0.004 for ASA grade 2 and 98.4% vs. 95.5, P = 0.006 for ASA grade 3).
For ASA grade 2 and 3 patients, the modified non-rebreathing mask significantly improves oxygen saturations during upper intestinal endoscopy. This technique should be more widely used for patients at moderate and high risk.
近期，上消化道内镜检查期间呼吸及其他并发症的显著发生率已引起关注。本前瞻性研究旨在比较在择期食管胃十二指肠镜检查期间使用两种不同给氧方法时氧饱和度降低的发生率和严重程度。
经当地医学伦理委员会批准并获得书面知情同意后，将100例行择期食管胃十二指肠镜检查的患者随机分组，分别通过鼻镜以每分钟4升的速度或通过特制改良无重复呼吸面罩以每分钟10升的速度给予补充氧气。记录在咪达唑仑镇静辅助下内镜检查期间的氧饱和度，并使用非参数检验比较两组的氧饱和度。
对于美国麻醉医师协会（ASA）2级和3级患者，在检查过程中，使用改良面罩吸氧的患者平均氧饱和度显著高于通过鼻镜吸氧的患者（ASA 2级为98.6%对97.0%，P = 0.004；ASA 3级为98.4%对95.5，P = 0.006）。
对于ASA 2级和3级患者，改良无重复呼吸面罩可显著提高上消化道内镜检查期间的氧饱和度。该技术应更广泛地应用于中高危患者。
