Comparative analysis of tracheal intubation anesthesia vs nontracheal intubation anesthesia for endoscopic treatment of esophagogastric varices

Abstract

BACKGROUND: Esophageal-gastro varices (EGV) is one of the common complications of cirrhosis, and esophageal gastric variceal bleeding (EGVB), characterized by acute onset and high severity, is one of the main causes of death in patients with cirrhosis. Painless endoscopic treatment is an important measure for the management of EGV rupture. At present, there are two ways of anesthesia: endotracheal intubation and non-tracheal intubation anesthesia. AIM: To compare the safety and economy of endotracheal intubation and non-tracheal intubation anesthesia for endoscopic treatment of EGV. METHODS: The study was performed in 58 patients with inactive bleeding who underwent endoscopic treatment for EGV from September 2017 to August 2018. They were randomly divided into an intravenous anesthesia group (non-intubation group) and a tracheal intubation anesthesia plus intravenous anesthesia group (intubation group). They were compared and analyzed in terms of basic conditions, safety, and economy. Measurement data were analyzed by the t test or rank sum test, and count data were analyzed by the chi-square test. RESULTS: SpO2 was significantly lower in the non-intubation group compared with the intubation group (P < 0.05), and there were no significant differences in blood pressure, heart rate, or other vital signs between the two groups (P > 0.05). The intraoperative incidence of adverse reactions such as nausea, cough, hiccup, and snoring was significantly higher in the non-intubation group than in the intubation group, but these had little effect on the operation. The induction time, recovery time, and total operative time of the non-intubation group were significantly shorter than those of the intubation group (P < 0.01). There was no significant difference in endoscopic treatment time, endoscopic treatment cost, total hospitalization cost, or hospitalization days between the two groups (P > 0.05), but the anesthesia cost was higher in the intubation group than in the non-intubation group (P < 0.01). CONCLUSION: For patients with inactive bleeding undergoing endoscopic treatment for EGV, both tracheal intubation and non-tracheal intubation anesthesia can provide good anesthetic effects, and non-tracheal intubation anesthesia has shorter induction time, quicker recovery and lower anesthesia cost, representing a safe and economical anesthesia method.