麻醉支持与内镜驱动镇静方式的结果:一个回顾性队列研究
Guozhen Xie1, Maria Estevez2, Kiyan Heybati1
1Mayo Clinic Alix School of Medicine, Mayo Clinic, Rochester, Minnesota, USA.
芬太尼/米达佐拉姆 (FM) 镇静用于内镜检查导致不良事件较少,但恢复时间较长,而不是与普罗波,普罗波与辅助剂 (PA) 或全身麻醉 (GA) 相比. 这项研究比较了超过56,000个手术中的镇静方法.
科学领域:
- 麻醉学 麻醉学
- 胃肠病学 胃肠病学
- 临床结果 临床结果
背景情况:
- 麻醉在程序设置中经常使用.
- 镇静方式在内镜医生和麻醉师之间有所不同.
- 对比恢复时间和不良事件对于患者的安全至关重要.
研究的目的:
- 为了比较内镜套房中的镇静方式.
- 评估与不同类型镇静药物相关的恢复时间和不良事件.
- 在胃肠道手术中提供最佳镇静实践的信息.
主要方法:
- 对接受EGD和/或结肠镜检查的成年患者进行回顾性队列研究.
- 将镇静分为四组:仅使用普罗波,普罗波±辅助剂 (PA),全身麻醉 (GA) 和芬太尼/米达佐拉姆 (FM).
- 主要结局:麻醉后护理单位 (PACU) 停留时间 (LOS);次要结局:手术后恶心和吐 (PONV),低氧化,急心和住院.
主要成果:
- 分析包括了56361个病例.
- 与普罗波,PA或GA (P < .0001) 相比,芬太尼/米达佐拉姆 (FM) 镇静显示出明显更长的PACU LOS.
- 与其他组相比,FM镇静的勃心脏病,缺氧,PONV和住院治疗率明显较低 (P < .05).
结论:
- 芬太尼/米达佐拉姆 (FM) 镇静与较低的不良事件发生率有关.
- 然而,FM镇静与显著更长的PACU LOS相关.
- 镇静选择涉及平衡不良事件率与恢复持续时间.
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