Effects of epinephrine-saline submucosal injection of different concentrations on endoscopic submuco-sal dissection
10.3760/cma.j.issn.1007-5232.2015.02.008
- VernacularTitle:内镜黏膜下剥离术中黏膜下注射用肾上腺素生理盐水浓度的初步研究
- Author:
Lei CHEN
;
Lu WANG
;
Zhen ZHU
;
Sujun GAO
;
Li ZHANG
;
Wei LU
;
Di CHEN
;
Haihang ZHU
- Publication Type:Journal Article
- Keywords:
Endoscopic submucosal dissection;
Injections;
Epinephrine;
Bleeding
- From:
Chinese Journal of Digestive Endoscopy
2015;(2):107-110
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evalute and compare the efficacy and safety of epinephrine-saline submu-cosal injection of different concentrations on endoscopic submucosal dissection (ESD),and to discuss the best concentration of submucosal injection.Methods A total of 128 patients who underwent ESD were ran-domly assigned to submucosal normal saline injection group (group A,n =32),0.001% epinephrine-saline injection group (group B,n =32),0.002% epinephrine-saline injection group (group C,n =32),and 0.004% epinephrine-saline injection group (group D,n =32).The incidence of bleeding during and after ESD were counted,the blood preasure and heart rate of preoperative and intraoperative,the amount of sub-mucosal injection,the time of operation were observed.Results ESD was successfully performed on all pa-tients.There were no difference in highest blood preasure and fastest heart rate between preoperative and in-traoperative results of each group.No perforation or intraoperative acute massive bleeding occurred.Intraop-erative acute minimal bleeding during ESD occurred in 9 patients in group A and 3 in group B,2 in group C and 2 in group D (P <0.05),but there were no differences among group B,C and D.The amount of submu-cosal injection of group A was(39.5 ±10.8)ml,which was more than that of group B(29.4 ±9.4)ml,group C(27.3 ±8.2)ml and group D(20.4 ±11.8)ml with significant difference.There were no differences a-mong group B,C and D,but there was less in group D than group B.The operation time of group A was(82.3 ±24.78 minutes),which was longer than that of group B (60.7 ±25.35minutes),group C (54.7 ± 31.72minutes)and group D(59.2 ±28.49 minutes),but there was no difference among B,C and D group. Conclusion Epinephrine-saline submucosal injection assiting ESD is safe and effective and reduces the op-eration time and bleeding than normal saline.The increase of the epinephrine-saline concentrations has not been found to be more beneficial.