Endoscopic esophageal varices ligation under topical anesthesia,sedation with consciousness or intravenous anesthesia:a comparison between three anesthetic methods / 中华消化内镜杂志

ABSTRACT

Objective To compare the efficacy and safety of topical anesthesia,conscious sedation and intravenous anesthesia during endoscopic varices ligation(EVL).Methods Patients underwent EVL were divided into 3 groups to receive different anesthetic methods,namely topical anesthesia,conscious sedation and intravenous anesthesia,with 50 subjects in each group.The changes of vital signs,the tolerance to stimulation of the procedure,the time of operation,the rate of complication were recorded and compared between 3 groups.Results The procedure of EVL were completed in all patients.In topical anesthesia group,40(80%)patients had nausea and vomiting,9 cases(1 8%)tried to pull out the endoscopy.The mucosa at the entrance of the esophagus were injured in 10 cases(20%).Massive bleeding occurred in 4 patients(8%)during operation because of nausea and vomiting.In conscious sedation group,only 7 patients(14%)had mild nausea and vomiting,and no complication of variceal bleeding occurred.The mucosa at the entrance of the esophagus was injured in 5 cases(10%).In intravenous anesthesia group,no patient had nausea or vomiting.The respiratory rate,heart rate and mean artery pressure decreased during the procedure,but without significant difference(P＞0.05).The operation time in intravenous anesthesia group WaS shorter than that in other two groups,but without significant difference(P＞0.05).Conclusion EVL can be completed under 3 different anesthetic methods,while EVL under conscious sedation is more effective and safe.