背景:在柔性支气管镜检查期间使用非麻醉师给药丙泊酚进行镇静的证据很少。这项研究的主要目的是确定与当前基于指南的镇静(咪达唑仑和阿片类药物联合)相比,非麻醉师给予异丙酚平衡镇静是否与更高的经皮CO2压力有关。次要结果是术后恢复时间,患者满意度和不良事件发生频率。
方法:在这项随机对照试验中,我们纳入了来自墨西哥北部一所大学医院的18岁或以上有弹性支气管镜检查指征的门诊患者的数据。
结果:纳入91例患者:咪达唑仑组42例,丙泊酚组49例。在60分钟的经皮二氧化碳测定监测,平均经皮CO2压力值在组间没有显著差异(43.6[7.5]vs.45.6[9.6]mmHg,P=.281)。丙泊酚与柔性支气管镜检查后5、10和15min的高Aldrete评分相关(9[IQR6-10]vs.10[9,10],P=.006;9[8-10]vs.10[IQR10-10],P<.001和10[IQR9-10]vs.10[10],分别),并在1(不满意)至10(非常满意)的视觉模拟量表上具有较高的患者满意度(8.41[1.25]vs.8.97[0.98],P=.03)。各组不良事件的频率相似(30.9%vs.22.4%,P=.47)。
结论:与指南推荐的镇静相比,非麻醉医师给予异丙酚平衡镇静与更高的经皮CO2压力或更频繁的不良反应无关.使用丙泊酚与较快的镇静恢复和较高的患者满意度相关。
背景:NCT02820051。
BACKGROUND: Evidence for the use of non-anesthesiologist-administered propofol for sedation during flexible bronchoscopy is scarce. The main objective of this study was to determine whether non-anesthesiologist-administered propofol balanced sedation was related to higher transcutaneous CO2 pressure compared with current guideline-based sedation (combination midazolam and opioid). Secondary outcomes were post-procedural recuperation time, patient satisfaction and frequency of adverse events.
METHODS: In this randomized controlled trial we included data from outpatients aged 18 years or older with an indication for flexible bronchoscopy in a university hospital in northern Mexico.
RESULTS: Ninety-one patients were included: 42 in the midazolam group and 49 in the propofol group. During 60min of transcutaneous capnometry monitoring, mean transcutaneous CO2 pressure values did not differ significantly between groups (43.6 [7.5] vs. 45.6 [9.6]mmHg, P=.281). Propofol was related with a high Aldrete score at 5, 10, and 15min after flexible bronchoscopy (9 [IQR 6-10] vs. 10 [9,10], P=.006; 9 [8-10] vs. 10 [IQR 10-10], P<.001 and 10 [IQR 9-10] vs. 10 [10], respectively) and with high patient satisfaction on a visual analogue scale of 1 (not satisfied) to 10 (very satisfied) (8.41 [1.25] vs. 8.97 [0.98], P=.03). Frequency of adverse events was similar among groups (30.9% vs. 22.4%, P=.47).
CONCLUSIONS: Compared with guideline-recommended sedation, non-anesthesiologist-administered propofol balanced sedation is not associated with higher transcutaneous CO2 pressure or with more frequent adverse effects. Propofol use is associated with faster sedation recovery and with high patient satisfaction.
BACKGROUND: NCT02820051.