Title

老年患者自控鎮靜與全靜脈鎮靜進行腸鏡檢查比較

Translated Titles

Patient-controlled Sedation Versus Intravenous Sedation for Colonoscopy in Elderly Patients: A Prospective Randomized Controlled Trial

Authors

陳培蓮(Pei-Lian Chen);謝新龍(Xin-Long Xie)

Key Words

結腸鏡 ; 患者自控鎮靜 ; 年病患者 ; 異丙酚 ; Coloscopy ; Patient controlled sedation ; Aged ; Propofol

PublicationName

中國臨床醫學

Volume or Term/Year and Month of Publication

12卷4期(2005 / 08 / 25)

Page #

657 - 659

Content Language

簡體中文

Chinese Abstract

Objective: A prospective randomized trial was conducted to compare the safety, effectiveness, and patient acceptance of patient-controlled sedation and intravenous sedation for colonoscopy in a group of elderly patients undergoing outpatient colonoscopy. Methods: One hundred patients over 65 years of age were recruited and randomized to patient controlled sedation (n=50)or intravenous sedation (n=50) groups by means of a computer-generated numbers. In the patient controlled sedation group, a mixture of propofol and alfentanil was delivered by means of a patient-controlled pump; each bolus delivered 4.8 mg propofol and l2ug alfentanil. No loading dose was used and lockout time was set at zero. In the intravenous sedation group, fixed doses of diazemuls (0.1mg/kg) and meperidine (0.5mg/kg) were given with further increases in dosages administered at the discretion of the endoscopist. Outcome measures assessed included cardiopulmonary complications, recovery time, pain score, and satisfaction score. Results: The mean (SD) age of patients in the patient-controlled sedation and intra venous sedation sedation groups were, respectively, 72.4 years (5.3) and 73.5 years (6.1). The mean dose of propofol consumed in the patient controlled sedation group was 0.89(0.56) mg/kg. The mean dose of diazemuls and meperidine consumed in intravenous sedation group were, respectively, 5.6(1.4) and 30.0(7.8) mg. Hypotention occurred in 3(6%) patients in the patient-controlled sedation sedation group and 15(30%) in the intravenous sedation group (P<0.01) Oxygen desaturation was recorded for 4 patients (8%) in the intravenous sedation group. The median (interquartile range (IQR) recovery time was significantly shorter in the patient-controlled sedation group compared with the intravenous sedation group (respectively, 1 minutes (IQR1-5) vs. 5 minutes (IQR5-10); P<0. 01). There were no statistically significant differences between groups for pain and satisfation scores. Conclusion: Patient-controlled sedation appears t be safer than intravenous sedation, with comparable effectiveness and acceptance, in elderly patients undergoing elective outpatient colonscopy.

English Abstract

Objective: A prospective randomized trial was conducted to compare the safety, effectiveness, and patient acceptance of patient-controlled sedation and intravenous sedation for colonoscopy in a group of elderly patients undergoing outpatient colonoscopy. Methods: One hundred patients over 65 years of age were recruited and randomized to patient controlled sedation (n=50)or intravenous sedation (n=50) groups by means of a computer-generated numbers. In the patient controlled sedation group, a mixture of propofol and alfentanil was delivered by means of a patient-controlled pump; each bolus delivered 4.8 mg propofol and l2ug alfentanil. No loading dose was used and lockout time was set at zero. In the intravenous sedation group, fixed doses of diazemuls (0.1mg/kg) and meperidine (0.5mg/kg) were given with further increases in dosages administered at the discretion of the endoscopist. Outcome measures assessed included cardiopulmonary complications, recovery time, pain score, and satisfaction score. Results: The mean (SD) age of patients in the patient-controlled sedation and intra venous sedation sedation groups were, respectively, 72.4 years (5.3) and 73.5 years (6.1). The mean dose of propofol consumed in the patient controlled sedation group was 0.89(0.56) mg/kg. The mean dose of diazemuls and meperidine consumed in intravenous sedation group were, respectively, 5.6(1.4) and 30.0(7.8) mg. Hypotention occurred in 3(6%) patients in the patient-controlled sedation sedation group and 15(30%) in the intravenous sedation group (P<0.01) Oxygen desaturation was recorded for 4 patients (8%) in the intravenous sedation group. The median (interquartile range (IQR) recovery time was significantly shorter in the patient-controlled sedation group compared with the intravenous sedation group (respectively, 1 minutes (IQR1-5) vs. 5 minutes (IQR5-10); P<0. 01). There were no statistically significant differences between groups for pain and satisfation scores. Conclusion: Patient-controlled sedation appears t be safer than intravenous sedation, with comparable effectiveness and acceptance, in elderly patients undergoing elective outpatient colonscopy.

Topic Category 醫藥衛生 > 醫藥衛生綜合