Discussion the value of topical pharyngeal anesthesia in patients undergoing painless gastrointestinal endoscopy examination / 中国医师进修杂志

ABSTRACT

Objective To explore the value of topical pharyngeal anesthesia combined with deep sedation anesthesia in patients undergoing painless gastrointestinal endoscopy examination.Methods One hundred and fifty patients were randomly divided into test group and control group,each group 75 patients.Before the examination the patients of test group were sprayed throat 1％ tetracaine three times,the patients of control group were not performed throat spray.All patients were given intravenous midazolam 1.0 mg before the examination,then all patients were given intravenous fentanyl 0.05 mg and intravenous injection of propofol when BIS was 55-65,the microscopy was given.If the patients had somatic reaction or BIS ＞ 70,additional propofol 0.3-0.5 mg/kg.The blood pressure (BP),heart rate (HR),venous oxygen saturation (SpO2),the dose of propofol and side effects were observed.Results The anesthetic effectsexcellent 59 cases,mild good 15 cases,no good 1 case in test group,excellent 53 cases,mild good 19 cases,no good 3 cases in control group,there was no significant difference (P ＞ 0.05).The level of SpO2,HR,MAP before anesthesia,during operation and after operation between two groups had no significant difference(P ＞ 0.05).The induction time and recovery time of anesthesia,the dose of propofol between two groups had no significant difference (P ＞ 0.05).The rate of restlessness,bucking,respiratory depression between two groups had no significant difference(P ＞ 0.05).In test group,pharyngeal portion unwell 37 cases,nausea 24 cases,tension 49 cases,and in control group was 0,0,12 cases,there was significant difference (P ＜ 0.05).Conclusions The use of deep sedation anesthesia with midazolam-fentanyl-propofol can not reduce the incidence of cough,respiratory depression and other side effects,but can increase the rate of pharyngeal portion unwell and nausea.The clinical value is limited.