| Objective:To compare the incidence of vigorous peristalsis of different parts of stomach and esophagus in endoscopic submucosal dissection (ESD) under tracheal intubation general anesthesia and investigate the effect of raceanisodamine for inhibiting peristalsis of upper digestive tract.Methods:76 patients were assigned to three groups:gastric antrum and gastric angle (A), gastric body and fundus (B) and esophagus and esophagogastric junction(C).39 patients were randomly divided into Al (with preoperative treatment of racemicanisodamine) and A2 (without racemicanisodamine). Anesthesia was induced with intravenous anesthetic agents and maintained with continuous intravenous injection of propofol and intermittent intravenous injection of fentanyl. Racemicanisodamine 10 mg was infused on the occurrence of vigorous peristalsis. The process of ESD operation was recorded by endoscopic video system for evaluation of peristalsis and operation. Preoperative basic conditions of patients, operation time, anesthesia time, extubation time, recovery time, dosage of propofol and postoperative patient conditions were also recorded.Results:Compared with group A, group B and group C had longer operation time and anesthesia time (p<0.05). The proportion of patients with vigorous peristalsis was significantly higher in group A(68.0%) than group B(4.8%) and C (3.3%) (p<0.01). The peristalsis score and operation score of group A was significantly higher than that of group B (p<0.01). The operation score of group A was significantly higher than the group C (p<0.01). Compared with group A2, group A1 had remarkably decreased proportion of patients with vigorous peristalsis (5.3% versus 80.0%, p<0.01) and lower peristalsis score and operation score (p< 0.05).Conclusion:In the process of ESD under general anesthesia, the incidence of vigorous peristalsis in patients with foci located on gastric antrum and angle was high, and preoperative use of raceanisodamine can ameliorate or inhibit these peristalsis. |
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