Anesthesia for esophageal endoscopic mucosal resection / 中华消化内镜杂志

ABSTRACT

Objective To observe efficacy and safety of 2 ways of intravenous anesthesia in endoscopic mucosal resection (EMR) for early esophageal cancer and its precancerous lesion.Methods A total of 140 patients with early esophageal cancer and its precancerous lesion undergoing EMR were enrolled and randomized into 2 groups, with 70 patients in each.Midazolam and propofol were used for group Ⅰ, while midazolam and etomidate were used for group Ⅱ.Vital signs, anesthetic effect, recovery time during the therapy, intra-operative and post-operative adverse reactions were compared.Results Anesthesia with both methods could reach the need for safe EMR.The blood pressure and heart rate of patients in group Ⅰ significantly decreased during the therapy, while no significant difference was found in those of group Ⅱ, but which was significantly different from those of group Ⅰ at some parts of the observation point (P＜0.05).Pulse oxygen saturation of all patients during the procedure was within normal range.No significant difference was found between 2 groups in recovery time.The incidence of muscle tremor or myoclonus in group Ⅱ was significantly higher than that of group Ⅰ, but the incidence of bradycardia and hypotension in group Ⅱ was lower than that of group Ⅰ (P＜0.05).Several patients complained pain, nausea and dizziness after therapy, but there was no significant difference between two groups. Conclusion Anesthesia with propofol and etomidate can both be applied to digestive endoscopy.Etomidate shows advantages in more stable hemodynamics.