| Objective: Conscious sedation is to use sedative / analgesic drugs to relieve patients’ fear,anxiety and intraoperative pain on the basis of local infiltration anesthesia,to eliminate the memory of harmful stimulation,and to improve patients’ comfort and acceptance.Its purpose is to make patients quiet,not anxious,attention drop and forgetting.Although they are slow in action,they still have the ability of language communication and cooperation,they can respond to the instructions and cooperate with the operation and examination,so that the operation can be carried out smoothly.In view of the lack of research on the sedative and analgesic effects of dezocine alone or in combination with diphenhydramine injection in general gastroscopy at home and abroad,this paper aims to explore the efficacy of dezocine injection and diphenhydramine hydrochloride injection and their combination in conscious sedation of gastroscopy,so as to improve the tolerance and compliance of patients with general gastroscopy,improve the examination effect and provide safety and effective treatment plan.Methods: A total of 120 subjects who needed general gastroscopy from June 2019 to December 2019 in the Second Hospital of Hebei Medical University were selected and divided into 4 groups according to the random number table method,with 30 cases in each group.Conscious sedation methods are: control group Group A: containing 10 ml dacrotonin hydrochloride glue + Placebo(1ml intramuscular injection of saline);Obser-vation group Group B: containing 10 ml dacrotonin hydrochloride glue + diphenhydramine hydrochloride injection(1ml:20mg)intramuscularly;Group C: containing 10 ml dacrotonin hydrochloride glue + dezocine injection(1ml: 5mg)intramuscularly;Group D: containing 10 ml dacrotonin hydrochloride glue + dezocine injection(1ml:5mg)intramuscularly + diphenhydramine hydrochloride injection(1ml:20mg)intramuscularly.Record T0 before the test,T1 during the test(after entering the esophagus from the pharynx),T2(when checking the stomach),T3(when checking the duodenum),T4(when checking the bottom of the stomach),T5(withdrawal Gastroscopy),the blood oxygen saturation(Sp O2),heart rate(HR),and blood pressure(Bp)values of the subject at each time period;record the nausea,cough,restlessness,nausea,dizziness and other adverse reactions of the subjects during the examination;record the subject’s tolerance evaluation,nausea score,comfort score,VAS score and whether to choose a general gastroscopy again if the condition requires;record the time taken for the entire gastroscopy(from the gastroscope to the mouth to the gastroscope removed).The study has been approved by the ethics committee of the second hospital of Hebei Medical University.All the patients in the study signed the informed consent.Results:There were statistically significant differences in tolerance,incidence of nausea during examination and composition of dizziness after examination among the four groups(P < 0.05).It was found that the incidence of adverse reaction nausea in group D was lower than that in group A(P < 0.0001),and that in group D was lower than that in group B(P = 0.04488),but there was no significant difference between group C and group B,group D,and between group A and group B,group C.The incidence of dizziness in group D was higher than that in group A(P < 0.0001),group D was higher than that in group B(P < 0.0001),and group C was higher than that in group B(P = 0.01674).The difference was statistically significant,but there was no significant difference between group A and group B,group C and Group D.There was no significant difference in tolerance between any two groups(P > 0.05).There was no significant difference in gender composition,VAS score,whether to choose common gastroscopy again,incidence of cough and agitation during examination,and incidence of nausea after examination between the four groups(P > 0.05).The difference of oxygen saturation between groups C was lower than that between group B and group D(P < 0.05);there was no significant difference in time effect(P > 0.05).The fluctuation of heart rate,systolic blood pressure and diastolic blood pressure in four groups: there was no significant difference between the groups(P > 0.05);there was significant difference in time effect(P < 0.05).It was found that the fluctuation of heart rate was statistically significant at any two time points,except t0 and T5.The heart rate of the four groups all increased faster during the T1 period,and began to slow down during the T2 period.The heart rate decreased to the lowest during the T5 period,but was still higher than the T0 period.The systolic and diastolic blood pressure of the four groups increased during the T1 period,T2 period gradually decreases,the period to T5 was minimized and there was no significant difference from T0.Conclusion: Conscious sedation is used before general gastroscope,given dizocine injection combined with diphenhydramine hydrochloride injection intramuscularly,can significantly reduce nausea and vomiting during the examination process,improve overall patient comfort,however,dizziness is prone to occur after examination. |
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