Results and Analysis of A Nationwide Survey on Painless Digestive Endoscopy in China_West China Medical Journal

Authors：

 ZHOUYu-kai ¹ , FANYa-ling ² , CHENQiu-xiang ³ , ZHOUXiang-yong ⁴ , WANGYing ¹

1. Department of Anesthesia, People's Hospital of Deyang City, Deyang, Sichuan 618000, P. R. China;
2. Department of Anesthesia, People's Hospital of Leshan City, Leshan, Sichuan 614000, P. R. China;
3. Department of Anesthesia, People's Hospital of Fengjie County, Fengjie, Chongqing 404600, P. R. China;
4. Department of Anesthesia, the Second Affiliated Hospital, Zhejiang University, Hangzhou, Zhejiang 310009, P. R. China;

Corresponding?author：

Keywords：

China; Sedation; Digestive system; Endoscopy; Questionnaires

DOI：

10.7507/1002-0179.20150585

Video：

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Objective To know the fundamental status of painless digestive endoscopy in China. Methods A 23-item survey including multiple choices and fill-in-the-blank questions on 3 pages was performed on anesthesiologists in China excluding Taiwan, Macao and Hong Kong on www.xqnmz.com and www.dxy.cn/bbs from November 1 to December 31, 2013, among which 5 questions were on personal details, 9 on hospital and department, and 9 on clinic details. The results about the basic facts, risk factors of anesthesia and drug use and monitoring of painless digestive endoscopy in China were analyzed. Results A total of 726 questionnaires were collected, among which 667 (91.87%) were considered valid. Interviewed hospitals included hospitals from 31 provinces, municipalities and autonomous regions excluding Taiwan, Macao and Hong Kong. Thirty questionnaires were from the first-grade hospitals (4.5%), 292 from the second-grade (43.78%), and 345 from the third-grade (51.72%). And 69.12% of the questionnaires showed these hospitals could only carry out painless gastroscopy and/or colonoscopy, while 80.81% showed the number of the mean painless endoscopy cases was 0-30 per day; 47.23% of the respondents working in digestive endoscopy center had to complete the anesthesia procedure alone, and 35.83% of the respondents illustrated their digestive endoscopy centers had established the post anesthesia care unit; 62.97% were equipped with anesthesia apparatus or ventilator; 89.96% were equipped with tracheal intubation tool; and 21.44% were equipped with defibrillator. Among them, 25.79% did not prepare rescue medicines regularly in digestive endoscopy center. Propofol was the most frequently used anesthetic, and composited fentanyl was at the highest use rate for gastrointestinal endoscopy. Respondents who used electrocardiogram, non-invasive blood pressure and pulse oxygen saturation the least to monitor during painless gastroscopy and colonoscopy took up 43.48% and 46.08% respectively. Conclusion Painless digestive endoscopy needs further development and standardization with the regulation of related guidelines and standardized residents training.

Citation： ZHOUYu-kai, FANYa-ling, CHENQiu-xiang, ZHOUXiang-yong, WANGYing. Results and Analysis of A Nationwide Survey on Painless Digestive Endoscopy in China. West China Medical Journal, 2015, 30(11): 2063-2066. doi: 10.7507/1002-0179.20150585 Copy

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2.	馬小軍, 楊鳳軍. 氯胺酮麻醉用于小兒纖維腸鏡檢查[J]. 第一軍醫大學學報, 1992, 12(2):126.
3.	曾莉, 吳新民. 不同劑量咪唑安定在纖維胃鏡檢查中的鎮靜作用[J]. 中華麻醉學雜志, 1998, 18(7):395-397.
4.	郝建宇, 王世鑫, 羅穎, 等. 經內鏡逆行胰膽管造影中清醒鎮靜麻醉的應用研究[J]. 中華消化內鏡雜志, 2002, 19(6):11-12.
5.	郝曉雯, 李鵬, 張澍田. 消化內鏡技術的發展與創新[J]. 首都醫科大學學報, 2013, 34(5):693-697.
6.	李曉梅, 郭蓮怡, 吳基洲, 等. 遼寧西部地區不同分級醫院消化內鏡使用、消毒管理現況調查[J]. 現代儀器與醫療, 2015, 21(1):103-105.
7.	Heuss LT, Froehlich F, Beglinger C. Changing patterns of sedation and monitoring practice during endoscopy:results of a nationwide survey in Switzerland[J]. Endoscopy, 2005, 37(2):161-166.
8.	賈麗娜, 康學智. 用互聯網構建中醫一脈相承的新模式——淺議互聯網普及背景下中醫傳承方式的變革[J]. 中國中醫藥現代遠程教育, 2014, 12(22):77-78.
9.	Wang HL, Ye F, Liao WF, et al. Unsedated versus sedated gastrointestinal endoscopy:a questionnaire investigation in Wuhan, central China[J]. J Huazhong Univ Sci Technol Med Sci, 2013, 33(6):857-861.
10.	Nagengast FM. Sedation and monitoring in gastrointestinal endoscopy[J]. Scand J Gastroenterol, 1993, 28(20):28-32.
11.	Waring JP, Baron TH, Hirota WK, et al. Guidelines for conscious sedation and monitoring during gastrointestinal endoscopy[J]. Gastrointest Endosc, 2003, 58(3):317-322.
12.	Yusoff IF, Raymond G, Sahai AV. Endoscopist administered propofol for upper-GI EUS is safe and effective:a prospective study in 500 patients[J]. Gastrointest Endosc, 2004, 60(3):356-360.
13.	Sebel PS, Lowdon JD. Propofol:a new intravenous anesthetic[J]. Anesthesiology, 1989, 71(2):260-277.
14.	Tohda G, Higashi S, Sakumoto H, et al. Efficacy and safety of nurse-administered propofol sedation during emergency upper endoscopy for gastrointestinal bleeding:a prospective study[J]. Endoscopy, 2006, 38(7):684-689.
15.	Thompson AM, Wright DJ, Murray W, et al. Analysis of 153 deaths after upper gastrointestinal endoscopy:room for improvement?[J]. Surg Endosc, 2004, 18(1):22-25.
16.	Külling D, Orlandi M, Inauen W. Propofol sedation during endoscopic procedures:how much staff and monitoring are necessary?[J]. Gastrointest Endosc, 2007, 66(3):443-449.

1. Bai Y, Li ZS. Evolution of gastrointestinal endoscopy in the mainland of China[J]. Chin Med J (Engl), 2009, 122(19):2220-2223.
2. 馬小軍, 楊鳳軍. 氯胺酮麻醉用于小兒纖維腸鏡檢查[J]. 第一軍醫大學學報, 1992, 12(2):126.
3. 曾莉, 吳新民. 不同劑量咪唑安定在纖維胃鏡檢查中的鎮靜作用[J]. 中華麻醉學雜志, 1998, 18(7):395-397.
4. 郝建宇, 王世鑫, 羅穎, 等. 經內鏡逆行胰膽管造影中清醒鎮靜麻醉的應用研究[J]. 中華消化內鏡雜志, 2002, 19(6):11-12.
5. 郝曉雯, 李鵬, 張澍田. 消化內鏡技術的發展與創新[J]. 首都醫科大學學報, 2013, 34(5):693-697.
6. 李曉梅, 郭蓮怡, 吳基洲, 等. 遼寧西部地區不同分級醫院消化內鏡使用、消毒管理現況調查[J]. 現代儀器與醫療, 2015, 21(1):103-105.
7. Heuss LT, Froehlich F, Beglinger C. Changing patterns of sedation and monitoring practice during endoscopy:results of a nationwide survey in Switzerland[J]. Endoscopy, 2005, 37(2):161-166.
8. 賈麗娜, 康學智. 用互聯網構建中醫一脈相承的新模式——淺議互聯網普及背景下中醫傳承方式的變革[J]. 中國中醫藥現代遠程教育, 2014, 12(22):77-78.
9. Wang HL, Ye F, Liao WF, et al. Unsedated versus sedated gastrointestinal endoscopy:a questionnaire investigation in Wuhan, central China[J]. J Huazhong Univ Sci Technol Med Sci, 2013, 33(6):857-861.
10. Nagengast FM. Sedation and monitoring in gastrointestinal endoscopy[J]. Scand J Gastroenterol, 1993, 28(20):28-32.
11. Waring JP, Baron TH, Hirota WK, et al. Guidelines for conscious sedation and monitoring during gastrointestinal endoscopy[J]. Gastrointest Endosc, 2003, 58(3):317-322.
12. Yusoff IF, Raymond G, Sahai AV. Endoscopist administered propofol for upper-GI EUS is safe and effective:a prospective study in 500 patients[J]. Gastrointest Endosc, 2004, 60(3):356-360.
13. Sebel PS, Lowdon JD. Propofol:a new intravenous anesthetic[J]. Anesthesiology, 1989, 71(2):260-277.
14. Tohda G, Higashi S, Sakumoto H, et al. Efficacy and safety of nurse-administered propofol sedation during emergency upper endoscopy for gastrointestinal bleeding:a prospective study[J]. Endoscopy, 2006, 38(7):684-689.
15. Thompson AM, Wright DJ, Murray W, et al. Analysis of 153 deaths after upper gastrointestinal endoscopy:room for improvement?[J]. Surg Endosc, 2004, 18(1):22-25.
16. Külling D, Orlandi M, Inauen W. Propofol sedation during endoscopic procedures:how much staff and monitoring are necessary?[J]. Gastrointest Endosc, 2007, 66(3):443-449.

West China Medical Journal

Results and Analysis of A Nationwide Survey on Painless Digestive Endoscopy in China

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