在气球辅助肠镜中持续与间歇的米达佐拉姆镇静:一个多中心随机试验
Digestion
|January 6, 2026
概括
在气球辅助肠镜术 (BAE) 中,连续输注米达佐拉姆并没有改善镇静时间,与间歇性玻尿酸相比. 然而,连续输液在BAE期间减少了患者的运动,而没有增加不良事件,提供了可行的镇静选择.
科学领域:
- 胃肠病学 胃肠病学
- 麻醉学 麻醉学
- 临床药理学 临床药理学
背景情况:
- 气球辅助肠镜 (BAE) 的镇静方案缺乏标准化.
- 米达佐拉姆通常用于BAE镇静,但施用方法各不相同.
- 对比连续输液与间歇性注射量米达佐拉姆对于优化BAE程序至关重要.
研究的目的:
- 为了比较持续注射米达佐拉姆的疗效和安全性与在BAE期间间歇性注射玻尿酸的效果.
- 为了确定连续输液是否在有意识镇静下提供更大比例的时间 (拉姆赛镇静量表得分为3-4).
- 评估二次结果,包括程序中断,患者和内镜师的满意度,药物剂量和不良事件.
主要方法:
- 一个多中心,前性,双盲,随机对照试验在15个日本国家医院组织机构进行.
- 接受诊断或治疗BAE的患者被随机分配,接受持续静脉注射米达佐拉姆输液或间歇性玻尿酸注射.
- 主要终点是意识镇静所花费时间的比例,次要终点评估程序和安全参数.
主要成果:
- 在连续输液和间歇性玻尿酸组之间,在意识镇静下时间的比例类似 (0.637±0.315对比0.609±0.272,p=0.721).
- 持续输液组表现出较少的身体运动导致程序中断的趋势 (7.9%对25.0%,p=0.091).
- 持续输液需要更高的总米达佐拉姆剂量,但不良事件发生率在两组之间是可比的.
结论:
- 连续的米达佐拉姆输液在BAE期间保持意识镇静方面并没有证明优于间歇性玻尿酸输液.
- 连续输液在BAE期间有效抑制身体运动,但不增加不良事件.
- 在临床实践中,持续的米达佐拉姆输液代表了BAE程序的可行镇静策略.
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