首页> 中文期刊>世界核心医学期刊文摘:胃肠病学分册 >清醒镇静状态下行诊断性微型腹腔镜和结肠镜检查期间发生心肺事件的前瞻性比较研究

清醒镇静状态下行诊断性微型腹腔镜和结肠镜检查期间发生心肺事件的前瞻性比较研究

     

摘要

Background and study aims: Cardiorespiratory parameters were examined throughout diagnostic minilaparoscopy procedures. The same parameterswere analyzed during colonoscopy, and the data were compared. Patients and methods: Sixty-five consecutive unselected patients undergoing minilaparoscopy (group 1: ASA I, n = 34; group 2: ASA II/III, n = 31) and 61 consecutive unselected patients undergoing colonoscopy (group 3: ASA I, n = 31; group 4: ASA II/III, n = 30)-were included. Oxygen saturation (Sao2), heart rate (HR) and mean arterial pressure (RRm) weremeasured continuously, and 12-lead electrocardiography (ECG) recordings were made at specific times during each procedure. Results: Minor differenceswere observed, particularly after premedication, probably due to different dosage regimens and timing in the two examination techniques. After premedication, testing for differences from baseline values showed a minor decrease in Sao2 and RRm in the minilaparoscopy groups in comparison with the colonoscopy groups (median Sao2, group 1: 99.9%±0 vs. group 3: 100%-1, P = 0.0078; median RRm, group 1: 99.5-4 mm Hg vs. group 3:96 -16 mm Hg, P = 0.046, and median RRm, group 2: 110 +1 mm Hg vs. group 4:101 -13.5 mmHg, P = 0.0007). HR increased in minilaparoscopy in comparison with colonoscopy (median HR: group 2:77 +4 beats/min vs. group 4:75.5 ±0 beats/min; P = 0.01). Comparison of defined relevant pathological changes in Sao2, RRm, HR, and ECG showed no significant differences. Discussion: These data indicate that diagnostic minilaparoscopy under conscious sedation is only associated with limited risk in patients with compensated cardiopulmonary diseases. This is probably due to the low insufflation pressure used.

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