Cv 170

Our outpatient clinic is equipped with a video rhinolaryngoscope and built-in NBI technology (CV-170; Olympus Medical System, Tokyo, Japan). The endoscopic examination was performed by a single experienced otolaryngologist with the patient in supine position. During the exam, a button allowed switching from white light endoscopy (WLE) to NBI. Ecocain^®, (Molteni Dental srl, Milan, Italy) Lidocaine, 10 g/mL; dose: 2 sprays was administered 15 min before the procedure. Transnasal endoscopic images were reproduced on a 1080 p monitor and all exams were recorded for remote replay and review by a second examiner. Lesions assessed in WLE were classified as benign (0), uncertain (1) or clearly malignant (2), depending on the opinion of each examiner. Using NBI, laryngeal lesions were categorized according to the classifications proposed by Ni et al. [6 (link)] as follows: (0) non-malignant (pattern type I and II); (1) suspected leucoplakia and high-grade dysplasia or carcinoma (pattern type III, IV and V). In case of concordance between diagnoses of the two examiners, the lesion was classified as described. In case of disagreement, both examiners reviewed the video of the endoscopy again and a joint diagnosis was expressed.

All patients need regular fasting for 12 hours and drinking for 8 hours before examination. Lateral prone position is taken, oxygen is inhaled by nasal catheter at 3.0 L/min, and ECG and heart rate are monitored by DASH4000 multifunctional monitor (GE). In the single-drug group, 0.9% normal saline is injected, and etomidate (Jiangsu Hengrui Pharmaceutical Co., Ltd., Production lot no. 20171015) is injected 2 min later at a rate of 0.2 mg/(kg/min). On the basis of the single-drug group, anesthesia induction is performed with remazolam (Jiangsu Hengrui Pharmaceutical Co., Ltd., Batch No. 200725) at 12 mg/(kg/h), and anesthesia is maintained at 1.0-2.0 mg/(kg·h). After the patient's consciousness disappeared, gastroenteroscopy (Olympus, Japan, model: CV-170) is performed. According to the patient's physical reaction during the examination, 4–6 mg etomidate is added appropriately. After the gastroenteroscopy reached the ileocecal area, the administration is stopped.