Carbon dioxide accumulation during analgosedated colonoscopy: Comparison of propofol and midazolam  

作　　者：Ludwig T Heuss Shajan Peter Sugandha Christoph Beglinger 

机构地区：[1]Department of Gastroenterology, University Hospital,4031 Basel, Switzerland

出　　处：《World Journal of Gastroenterology》2012年第38期5389-5396,共8页世界胃肠病学杂志（英文版）

摘　　要：AIM: To characterize the profiles of alveolar hypoventilation during colonoscopies performed under sedoanalgesia with a combination of alfentanil and either midazolam or propofol. METHODS: Consecutive patients undergoing routine colonoscopy were randomly assigned to sedation with either propofol or midazolam in an open-labeled design using a titration scheme. All patients received 4 μg/kg per body weight alfentanil for analgesia and 3 L of supplemental oxygen. Oxygen saturation (SpO 2 ) was measured by pulse oximetry (POX), and capnography (PcCO 2 ) was continuously measured using a combined dedicated sensor at the ear lobe. Instances of apnea resulting in measures such as stimulation of the patient, a chin lift, a mask maneuver, or withholding of sedation were recorded. PcCO 2 values (as a parameter of sedation-induced hypoventilation) were compared between groups at the following distinct time points: baseline, maximal rise, termination of the procedure and 5 min after termination of the procedure. The number of patients in both study groups who regained baseline PcCO 2 values (± 1.5 mmHg) five minutes after the procedure was determined.RESULTS: A total of 97 patients entered this study. The data from 14 patients were subsequently excluded for clinical procedure-related reasons or for technical problems. Therefore, 83 patients (mean age 62 ± 13 years) were successfully randomized to receive propofol (n = 42) or midazolam (n = 41) for sedation. Most of the patients were classified as American Society of Anesthesiologists (ASA) Ⅱ [16 (38%) in the midazolam group and 15 (32%) in the propofol group] and ASA Ⅲ [14 (33%) and 13 (32%) in the midazolam and propofol groups, respectively]. A mean dose of 5 (4-7) mg of Ⅳ midazolam and 131 (70-260) mg of Ⅳ propofol was used during the procedure in the corresponding study arms. The mean SpO 2 at baseline (%) was 99 ± 1 for the midazolam group and 99 ± 1 for the propofol group. No cases of hypoxemia (SpO 2 < 85%) or apnea were recorded. However, an increase in PAIM： To characterize the profiles of alveolar hypoventilation during colonoscopies performed under sedoanalgesia with a combination of alfentanil and either midazolam or propofol. METHODS： Consecutive patients undergoing routine colonoscopy were randomly assigned to sedation with either propofol or midazolam in an open-labeled design using a titration scheme. All patients received 4 μg/kg per body weight alfentanil for analgesia and 3 L of supplemental oxygen. Oxygen saturation （SpO 2 ） was measured by pulse oximetry （POX）, and capnography （PcCO 2 ） was continuously measured using a combined dedicated sensor at the ear lobe. Instances of apnea resulting in measures such as stimulation of the patient, a chin lift, a mask maneuver, or withholding of sedation were recorded. PcCO 2 values （as a parameter of sedation-induced hypoventilation） were compared between groups at the following distinct time points： baseline, maximal rise, termination of the procedure and 5 min after termination of the procedure. The number of patients in both study groups who regained baseline PcCO 2 values （± 1.5 mmHg） five minutes after the procedure was determined.RESULTS： A total of 97 patients entered this study. The data from 14 patients were subsequently excluded for clinical procedure-related reasons or for technical problems. Therefore, 83 patients （mean age 62 ± 13 years） were successfully randomized to receive propofol （n = 42） or midazolam （n = 41） for sedation. Most of the patients were classified as American Society of Anesthesiologists （ASA） Ⅱ [16 （38%） in the midazolam group and 15 （32%） in the propofol group] and ASA Ⅲ [14 （33%） and 13 （32%） in the midazolam and propofol groups, respectively]. A mean dose of 5 （4-7） mg of Ⅳ midazolam and 131 （70-260） mg of Ⅳ propofol was used during the procedure in the corresponding study arms. The mean SpO 2 at baseline （%） was 99 ± 1 for the midazolam group and 99 ± 1 for the propofol group. No cases of h

关 键 词：Colonoscopy Deep sedation Propofol Hypoventilation Blood gas monitoring Transcutaneous 

分 类 号：R574.62[医药卫生—消化系统]