儿童食管胃十二指肠镜插管与不插管的比较

E. Abraham, Jesus S. Apuya, M. S. Siddiqui, Taranjit S. Sangari, Tariq Parray, D. Harrison
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摘要

背景:对于行食管胃十二指肠镜检查(EGDs)的儿童患者,提供深度镇静或全身麻醉的方法多种多样。它的范围从静脉镇静,注入,异丙酚镇静和气管插管全身麻醉。一些研究发现,不插管治疗egd的儿科患者比插管的并发症更多。对EGD患儿插管是否比不插管更安全仍存在争议。因此,我们比较了气管插管与未气管插管的EGDs患儿。方法在获得IRB批准后,对一年内进行的EGDs进行回顾性图表审查。纳入的患者患有EGDs,年龄在2至18岁之间,ASA I或II, BMI小于30。我们纳入了200名在EGDs期间插管的受试者和200名在EGDs期间未插管的受试者。两组之间的比较包括恶心或呕吐、误吸、喉痉挛、喉咙痛、吞咽困难和呼吸抑制等不良事件。并比较总手术时间、转手术前麻醉时间、恢复时间和出院时间。结果两组患者不良结局无显著差异。唯一有统计学意义(p< 0.05)的变量是转手术前的麻醉时间(TOTS),未插管组的恢复时间比插管组短。结论未插管患者的并发症发生率不高于插管患者。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Comparison Between Intubating and Not Intubating Pediatric Patients for Esophagogastroduodenoscopy
Background There are wide array of methods in providing deep sedation or general anesthesia to pediatric patients having esophagogastroduodenoscopy (EGDs). It can range from intravenous sedation, insufflation, propofol sedation, and endotracheal intubation with general anesthesia. Some studies found that not intubating pediatric patients for EGDs were associated with more complications than intubating them. There is still controversy whether intubating is safer than not intubating EGD pediatric patients. Thus, we compared intubating versus not intubating pediatric patients undergoing EGDs. MethodsAfter getting IRB approval, a retrospective chart review was performed on EGDs performed during a one year time period. Patients included had EGDs, were between 2 and 18 years old, ASA I or II, and had a BMI less than 30. We included 200 subjects who were intubated during EGDs and 200 subjects who were not intubated during EGDs. Comparisons between the groups included adverse events such as nausea or vomiting, aspiration, laryngospasm, sore throat, dysphagia, and respiratory depression. Total surgical time, anesthesia time before turnover to surgeon, time to recovery, and time to discharge was also compared. ResultsThere was no significant difference in adverse outcomes between the two groups. The only variable that was statistically significant (p< .05) was the anesthesia time before turnover to surgeon (TOTS), with the time to recovery being shorter in the not intubated group compared to the intubated group.ConclusionsThere was not a higher incidence of complication in patients who were not intubating compared to the patients intubated.
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