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Objective To explore the clinical effect of intranasal dexmedetomidine as premedication on sedation and analgesia during painless electronic colonoscopy in children, and to investigate its optimal dose. Methods Ninety children scheduled for painless electronic colonoscopy were divided into three groups by using a computer?generated randomization schedule, 30 per group. Children were pretreated with 0. 2 mg/kg midazolam ( group A) , 1. 0μg/kg dexmedetomidine ( group B) or 2. 0μg/kg dexmedetomidine ( group C) by nasal drip 30 min before operation. The anesthesia protocol was programmed by propofol in the three groups. After eyelash reflex disappeared, the examination was performed. Mean artery blood pressure ( MAP ) , heart rate (HR), respiratory rate (RR) and oxygen saturation (SPO2) of children were recorded at 10 min before intranasal administration ( T0 ) , 30 min after intranasal administration ( T1 ) , at the onset of eyelash reflex disappearance ( T2 ) and the onset of examination initiating( T3 ) , at lens passing through splenic flexure ( T4 ) , or through hepatic flexure ( T5 ) , at the end of examination ( T6 ) and when patients were fully awake ( T7 ) , respectively. Bispectral index ( BIS) and the observer's assessment of alertness/sedation scale ( OAA/S) were performed at 10 min before intranasal administration ( T0 ) , 10 min, 20 min and 30 min after intranasal administration in the three groups. Mood score at parent?children separation and venipuncture acceptance score were also recorded. The adverse reactions during examination were analyzed. The above observed indices were compared among the three groups. If there was statistical difference ( P<0. 05 ) , pairwise comparison was performed ( P<0. 017) . Results The children's haemodynamics were all stable in the three groups. Compared with group A and group B at the same time point, BIS and OAA/S were all lower ( P<0. 017) in 10 to 30 min after intranasal administration in group C. Compared with group A and group B, mood score at parent?children separation and venipuncture acceptance score were both higher ( P<0. 017) in group C. Compared with group A and B, anesthetic revival time and consumption of propofol were shorter or lower in group C (P<0. 017). Compared with group A and group B, the incidences of intraoperative adverse reactions including hypertension, sinus tachycardia, restless moving and postoperative restlessness were all lower in group C(P<0. 017). The rate of intranasal stimulus in group B and group C were both lower than that of group A( P<0. 017) . The rate of injection pain of group C was lower ( P<0. 017 ) than that of group A and B. Conclusion Intranasal administration of dexmedetomidine can be safely applied to children receiving painless electronic colonoscopy, and it can improve children's compliance effectively and yield to satisfactory anesthetic effect. Moreover, the administering efficacy of dexmedetomidine with the dose of 2. 0μg/kg was superior to 1. 0μg/kg.
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Objective To analyze the usefulness of homogenate diet when applying for the bowel preparation in electronic colonoscopy. Methods one hundred and eighty patients were selected in Nanjing drum tower hospital from October 2015 to May 2016, including 90 cases in the treatment group and 90 cases in the control group. Using the Boston Bowel Preparation Scale, the intestinal tract cleanness and the adverse reaction between two groups were compared. Results The treatment group was better in the intestinal cleanliness compared with the control group, there was statistical difference (transversostomy:χ2=8.545, P=0.014;left colon:χ2=8.430, P=0.015). Adverse reactions in the treatment group was significantly lower than the control group (χ2=4.305, P=0.004). Conclusions Homogenate diet can guarantee nutrition supply before the preoperative, improve bowel preparation efficiency and reduce the incidence of adverse reactions.
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Objective To investigate the electrocardiogram analysis of electronic colonoscopy on patients with coronary artery heart disease,and to evaluate the safety of colonoscopy on patients with coronary artery heart disease.Methods Sixty patients who underwent colonoscopy from Jun.2012 to Jun.2013 were divided into experimental group (patients with coronary artery heart disease,Heart function class Ⅰ-Ⅲ) and control group (patients without coronary artery heart disease).The changes of electrocardiography during colonoscopy and before performance were compared between two groups through dynamic electrocardiogram.Results Heart rate of the two groups were no statistically significant difference before colonoscopy process (t =0.537,P ＞ 0.05).During the inspection process,there was heart rate increase at different degree in two groups.The heart rate in patients of experiments group was increased from (73.20 ± 7.91) times/min to (88.67 ± 7.79) times/min,which waas more than that in control group (from (73.40 ±6.44) times/min to (74.88 ±7.82) times/min),and the difference between the two groups was significant(t =4.462,P ＜ 0.05).During colonoscopy inspection,the arrhythmia rate arrhythmia in experiment and control group were 46.67％ (14/30),20.00％ (6/30),and the difference was statistically significant (x2 =4.8,P ＜0.05).Meanwhile,ST-T change rates in experimental group and control group were 26.7％ (8/30) and 10.0％ (3/30) (x2 =45.72,P ＜ 0.05).The rate of subjective discomfort the two groups were 40％,30％ (x2 =0.659,P ＞ 0.05).Conclusion During the inspection process of colonoscopy,patients with coronary heart disease are more susceptible to increase heart rate,cardiac arrhythmia,ST-T change than those without coronary heart disease.However,no serious electrocardiographic changes.It is relatively safe to get colonoscopy in patients with coronary heart disease.
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Objective To investigate the effect of nursing intervention on bowel cleaning of patients with senile constipation during electronic bowel preparation for colonoscopy.Methods Forty patients with senile constipation undergoing routine bowel preparation for colonoscopy were treated with nursing intervention.The bowel cleaning effect and the satisfaction degree after bowel cleaning were assessed. Results The qualification rate of bowel cleaning reached 92.5%,and the excellence rate of cleaning comfort 95.0%.Conclusion The pertinent nursing intervention to the elderly patients with constipation undergoing electronic colonoscopy may improve the rate of cleaning the bowels as well as their level of comfort so that the patients can live smoothly through the electronic colonoscopy.
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Objective To investigate the influence of oral intake of goop before oral intestinal cleaning drugs on blood glucose,cleansing effect and tolerance of patients.Methods 88 patients who were prepared for intestinal examination or bowel treatment with enteroscope were randomly divided into the food-intake group (group A) and the fasting group (group B) with 44 cases in each group.Group A was given goop 2.5 hours before oral intake of intestinal cleansing drugs,group B fasted before oral intake of intestinal cleansing drugs.Blood glucose was monitored before as well as 6 hours after oral intake of intestinal cleansing drugs.Intestinal cleansing effect was evaluated during intestinal examination or bowel treatment with enteroscope.Cases of patients who ceased intestinal examination or bowel treatment with enteroscope due to intolerance were summarized.The blood glucose,cleansing effect and tolerance of patients were compared between two groups.Results There was significant difference in blood glucose between the two groups before and after oral intake of intestinal cleansing drugs.The cleansing effect showed no significant difference,but the difference of tolerance between two groups was significant.Conclusions Intake of goop 2.5 hours before oral intake of intestinal cleansing drugs does not affects intestinal cleansing effect,and it can obviously increase the blood sugar,improve tolerance of patients,thus ensure the smooth completion of intestinal examination or bowel treatment with enteroscope.