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Endoskopie heute 2013; 26(4): 248-253
DOI: 10.1055/s-0033-1356061
Originalarbeit
© Georg Thieme Verlag KG Stuttgart · New York

Einsatz von Lachgas zur Sedierung, Analgesie und Anxiolyse bei der ambulant durchgeführten Koloskopie

Nitrous Oxide Inhalation for Sedation, Analgesia and Anxiolysis in Out-Patient Colonoscopy
E. Karsten
1   Darmpraxis Wuppertal Koloproktologie, Gathe 70, 42107 Wuppertal
,
E. Berg
2   Prosper-Hospital, Abteilung für Koloproktologie, Mühlenstr. 27, 45659 Recklinghausen
,
K. P. Jung
2   Prosper-Hospital, Abteilung für Koloproktologie, Mühlenstr. 27, 45659 Recklinghausen
,
S. Kersting
2   Prosper-Hospital, Abteilung für Koloproktologie, Mühlenstr. 27, 45659 Recklinghausen
› Author Affiliations
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Publication History

Publication Date:
02 January 2014 (online)

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Zusammenfassung

Einleitung: Ohne Sedierung ist die Koloskopie für die meisten Patienten eine belastende Untersuchung. Die intravenöse Gabe von Sedativa und Analgetika allerdings ist mit dem möglichen Auftreten kardiopulmonaler Nebenwirkungen und somit einem postinterventionellen Monitoring verbunden. Lachgas bietet eine Alternative zur i. v. Sedierung. In Deutschland ist die Anwendung von Lachgas noch wenig verbreitet. Aus diesem Grund war es das Ziel dieser Studie, die praktische Anwendung von Lachgas in einer koloproktologischen Praxis im Hinblick auf die sedierende, analgetische und anxiolytische Wirkung bei der Koloskopie zu untersuchen.

Methode: Vom 1.9.2012 bis zum 30.9.2012 wurde bei 86 Patienten eine Koloskopie unter Sedierung mit einem 50 %igen Lachgas/Sauerstoff Gemisch (Livopan®) durchgeführt. Die Sedierungstiefe wurde während der Untersuchung nach dem Richmond Agitation Sedation Score (RASS) eingestuft. Nach Abschluss der Untersuchung beurteilten die Patienten den empfundenen Schmerz mithilfe der Numerischen Rating Skala (NRS).

Ergebnisse: Die mittlere Dauer der Koloskopien unter Lachgas lag bei 17 Minuten. Die vom Patienten empfundene Schmerzsymptomatik lag im Mittel bei 1,4 nach NRS und war damit minimal. Bei einem mittleren RASS von –1,4 waren die Patienten schläfrig bis leicht sediert.

Schlussfolgerung: Die kontinuierliche Gabe von 50 % Lachgas stellt eine gute Alternative zur i. v. Sedierung dar, da sie eine ausreichende Analgesie bei wachem und kooperativem Patienten gewährleistet.

Abstract

Introduction: Without sedation colonoscopy is often experienced as very painful. However, intravenous sedation and analgesia are associated with a definite risk of cardiopulmonary complications and require monitoring after the examination. Nitrous oxide provides an alternative to i. v. sedation. In Germany the inhalation of nitrous oxide for colonoscopy is not very common. The aim of this study was to investigate the efficacy of nitrous oxide with regard to sedation, analgesia and anxiolysis in out-patient colonoscopy.

Methods: From 1st of September to 30th of September 2012, 86 patients received 50 % nitrous oxide/oxygen (Livopan®) for sedation during colonoscopy. During colonoscopy the Richmond Agitation Score (RASS) was used for qualification of the depth of sedation. After the completion of the examination patients were asked to select the number that represented their pain intensity during colonoscopy on the 11-point (0 – 10) Numeric Rating Scale (NRS).

Results: Colonoscopy under nitrous oxide had an average duration of 17 minutes. Pain was low and related to an average severity of 1.4 on NRS. Patients were drowsy or lightly sedated with an average RASS of –1.4.

Conclusion: Continuous inhalation of 50 % nitrous oxide is a good alternative to i. v. sedation in colonoscopy as it provides adequate analgesia in alert and cooperative patients.

Schlüsselwörter

Koloskopie - Lachgas - Livopan® - Sedierung - Analgesie

Key words

colonoscopy - nitrous oxide - Livopan® - sedation - analgesia
 

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