低流量笑氧混合气体吸入镇静技术在消化内镜检查中的应用

Application of low concentration nitrous oxide and oxygen gas mixture in digestive endoscopy

目的:分析低流量笑氧混合气体技术在消化内镜应用中的安全性。方法:选择2011年1月至2011年4月在我院行胃肠镜检查患者233例,随机分为笑气组和普通组,笑气组应用单纯低浓度笑氧混合气体吸入麻醉行胃肠镜检查,普通组不实施麻醉,观察检查前吸入笑气即刻与检查结束后吸入纯氧即刻患者心率,血压,血氧饱和度;记录患者的镇静效果、不适感程度、检查时间;评估检查成功率;观察患者神志改变,清醒状况;记录患者苏醒时间。结果:笑气组不良反应中恶心和呛咳的发生率较普通组低(P=0.000),结肠镜检查疼痛程度明显低于普通组(P=0.004),应用笑氧混合气体吸入镇静技术行胃镜检查镇静效果能达到2级以上,肠镜检查达到3级以上,两组心率、血压及血氧饱和度差异无统计学意义(P>0.05)。结论:单纯低浓度笑氧混合气体吸入麻醉行胃肠镜检查可缓解患者焦虑情绪,有镇静、镇痛作用,增加检查的舒适度,而对患者的心率、血压及血氧饱和度无明显影响。

Objective： To analyze the safety of low concentration nitrous oxide and oxygen gas mixture in digestive endoscopy. Methods： Patients undergoing gastrointestinal endoscopy in our hospital from January 2011 to April 201 l were divided into the nitrous oxide group and control group. The patients in the nitrous oxide group received simple inhalation anesthesia of low concentration nitrous oxide and oxygen gas mixture during the gastrointestinal endoscopy, while the control group received no anesthesia. Observation indexes included the heart rate, blood pressure and oxygen saturation of patients at the time of nitrous oxide inhalation before examination and oxygen inhalation after examination, sedative ef- fect; degr~ of discomforts; examination time; success rate of examination; state and change of patients＇ conscionsness; and the recovery time of patients. Results： The incidence of nausea and bucking in the nitrous oxide group was lower than that of the control group （P=0.000）. The pain degree felt by patients of the nitrous oxide group during colonoscopy was significantly lower than that of the control group （P=O.000）. The inhala- tion sedation of nitrous oxide and oxygen gas mixture could reach a sedative effect above grade 2 in gastroscopy and above grade 3 in en- teroseopy. The heart rate, blood pressure and oxygen saturation of two groups showed no statistically significant difference （P〉0.05）. Conclusion： Simple inhalation anesthesia of low concentration nitrous oxide and oxygen gas mixture during gastrointestinal endoscopy can relieve the anxiety of patients, reach a sedative and analgesic effect, and reduce the discomfort of examination, without obvious influence on the heart rate, blood pressure and oxygen saturation of patients.