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High-flow nasal oxygen availability for sedation decreases the use of general anesthesia during endoscopic retrograde cholangiopancreatography and endoscopic ultrasound

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World Journal of Gastroenterology 2016年第47期22卷 10398-10405页

作者： roman Schumann Nikola S Natov Klifford A rocuts-Martinez Matthew D Finkelman tom V Phan sanjay r Hegde robert M Knapp Department of Anesthesiology and Perioperative Medicine Tufts Medical CenterBoston MA 02111United States The Gastroenterology/Hepatology Division Tufts Medical CenterBoston MA 02111United States Critical Care Medicine Dartmouth-Hitchcock Medical CenterLebanon NH 03756 United States Tufts University School of Dental Medicine Boston MA 02111United States Tufts University School of Medicine Boston MA 02111United States

AIM To examine whether high-flow nasal oxygen(HFNO) availability influences the use of general anesthesia(GA) in patients undergoing endoscopic retrograde cholangiopancreatography(ErCP) and endoscopic ultrasound(EUS) and associated *** In this retrospective study, patients were stratified into 3 eras between October 1, 2013 and June 30, 2014 based on HFNO availability for deep sedation at the time of their endoscopy. During the first and last 3-mo eras(era 1 and 3), no HFNO was available, whereas it was an option during the second 3-mo era(era 2). The primary outcome was the percent utilization of GA vs deep sedation in each period. Secondary outcomes included oxygen saturation nadir during sedation between periods, as well as procedure duration, and anesthesia-only time between periods and for GA vs sedation cases *** During the study period 238 ErCP or EUS cases were identified for analysis. Statistical testing was employed and a P rroni correction for multiple comparisons was used. General anesthesia use was significantly lower in era 2 compared to era 1 with the same trend between era 2 and 3(P = 0.012 and 0.045 respectively). The oxygen saturation nadir during sedation was significantly higher in era 2 compared to era 3(P ras 1 and 2(P = 0.028) or 1 and 3(P = 0.069). The procedure time within each era was significantly longer under GA compared to deep sedation(P ≤ 0.007) as was the anesthesia-only time(P ≤ 0.001).CONCLUSION High-flow nasal oxygen availability was associated with decreased GA utilization and improved oxygenation for ErCP and EUS during sedation.

关键词：内视镜的超声内视镜后退 cholangiopancreatography 内视镜检查法镇静麻醉氧化高流动鼻音氧

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