Prevention and treatment of complications of propoful sedation and anesthesia during gastroscopy / 中华消化内镜杂志

ABSTRACT

Objective To alleviate or prevent the complication of propoful sedation and anesthesia during gastroscopy. Methods One thousand three hundred and fifty eight patients were undergone gastrosco-py under propoful sedation and anesthesia. Results Although some patients with intravenous use of propofol their blood pressure, heart and respiratory rate decreased in different extents, but others remained in normal range. During the operation, two cases(0. 15% )had hypotension which could be corrected after intravenous use of ephetonin; three cases (0. 22% ) had bradycardia that was restored after intravenous use of atropine; three hundred and eighteen cases (23. 42% )had cough which could be prevented by increasing the first dose of propofol and avoiding the pharyngeal simulation derived from operation; sixteen cases( 1. 18% )had serious chock accompanied with decreasing of blood oxygen saturation which could be alleviated by aspirating the guttural secretion, driving up the patients mandible and increasing oxygen inhalation, keeping the gastroscope dry and avoiding pumping water or air as passing through epiglottis are the effective methods in preventing chock. Forty six cases (3. 39% ) complained of pain in the injection site which could be alleviated by choosing a major vein and injecting drug slowly; forty three cases(3. 17% ) had nausea and two cases(0. 15% ) had phreno muscular spasm which could be alleviated or prevented by skilled manipulation; thirty nine cases (2. 87% )had vertigo after regaining consciousness, keeping in bed or deferring to wake the patient up are very effective in preventing and alleviating this symptom. Conclusion Although gastroscopy under propoful' s sedation and anesthesia is safe and effective, logical precautions are the keys to attain success and lessen complications.