A comparitive study between conscious sedation by nitrous oxide inhalation and intravenous sedation with propofol for upper gastrointestinal endoscopy
10.3760/cma.j.issn.1007-5232.2014.11.008
- VernacularTitle:笑气清醒镇静镇痛与丙泊酚静脉麻醉用于胃镜检查的临床价值比较研究
- Author:
Shenghao XU
;
Hui YUE
;
Qingfeng LI
;
Wenjuan YANG
;
Fengjian HE
;
Sanhua DENG
;
Qianqian PENG
;
Suying LIU
- Publication Type:Journal Article
- Keywords:
Gastroscopy;
Nitrogen oxides;
Propofol;
Conscious sedation
- From:
Chinese Journal of Digestive Endoscopy
2014;(11):645-649
- CountryChina
- Language:Chinese
-
Abstract:
Objective To study the induction of nitrous oxide(N2 O)and to compare safety and effec-tiveness of conscious sedation by nitrous oxide inhalation and intravenous sedation with propofol for upper gas-trointestinal(UGI)endoscopy.Methods A total of 400 patients undergoing UGI endoscopy in our hospital from April 2013 to October 2013 were randomly assigned to two groups,N2 O inhalation group(n=200)and in-travenous propofol group(n=200).The systolic pressures,diastolic pressures,heart rates and oxygen satura-tion,onset time,procedure duration,degree of sedation,recovery time,length of hospital stay,complica-tions,satisfaction ratings of doctors and patients,and the number of patients willing to accept the examination again were analyzed.Results The mean time of ideal anesthesia state for N2 O was (3. 16 ±0. 65 )min and there was no difference between the male and female(3. 16 ±0. 71)min vs.(3. 16 ±0. 58)min,t=0. 006,P>0. 05).The mean concentration was (43. 68 ±5. 05 )%,which was higher in male than that in female [(45. 3 ±4. 99)% vs.(41. 46 ±4. 30)%,t=3. 042,P<0. 05].Compared with before,the systolic pres-
sures,diastolic pressures,heart rates and oxygen saturation of patients in the propofol group significantly re-duced during the procedure(P<0. 05),while the same measurements excluding oxygen saturation for those in the N2 O group significantly increased(P<0. 05 ).Compared with the propofol group,patients inhaling N2 O had significantly shorter recovery and hospital stay time,but a longer onset time and procedure duration(P<0. 05 ).Complications that occurred in some patients of propofol group included hyoxemia,hypotension,brady-cardia,while the major complication in the N2 O group was nausea.The satisfaction ratings of doctors or pa-tients and the number of patients willing to accept the examination again in N2 O group were smaller than those in propofol group(86 ±3. 7 vs.96 ±2. 6,87 ±2. 8 vs.98 ±1. 2,87%vs.99%,P<0. 05).Conclusion Both conscious sedation by N2 O inhalation and intravenous sedation with propofol are effective for diagnostic UGI en-doscopy,but the safety of the former is superior to the latter.The key to complete the conscious sedation by ni-trous oxide inhalation is to accurately identify the ideal anesthesia state of N2 O.It is significant to pay attention to the nine factors concerning safe and effective sedation during operation.
