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Low-Dose PropofolSedation forDiagnosticEsophagogastroduodenoscopy: Results in10,662 Adults Akira HoriuchiYoshiko NakayamaNao Hidaka2009 год

Low-Dose Propofol Sedation for Diagnostic Esophagogastroduodenoscopy: Results in 10,662 Adults
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Аннотация: OBJECTIVE: The use of propofol sedation during endoscopic procedures has increased in recent years. The aim of this study was to evaluate the safety and effectiveness of nurse-administered low-dose propofol sedation for diagnostic esophagogastroduodenoscopy (EGD). METHODS: We prospectively assessed the outcome and complications of low-dose bolus propofol for endoscopic sedation for diagnostic EGD. Propofol was administered by bolus injection, with a standard protocol of 40 mg for patients <70 years old, 30 mg for patients 70-89 years old, and 20 mg for patients 90 years or older. When required for adequate sedation, additional doses were given, to a maximum of 120 mg. The primary outcome measure was respiratory depression, defined as oxygen desaturation (SpO2 <90%) that continued for more than 20s. Secondary measures included successful procedures, full recovery within 60 min of the procedure, and complications. RESULTS: All procedures were successful; 8,431 of 10,662 patients (79.1%) completed diagnostic EGD with a single bolus of propofol. Only 0.26% (28 patients) required transient supplemental oxygen supply; neither mask ventilation nor endotracheal intubation was required. Full recovery occurred in 99.9% of patients 60 min after the procedure. Men and younger patients required significantly higher doses of propofol than did the women and older patients (men vs. women, 46.5±19 vs. 42.7±15 mg,P= 0.0008; age 40-49 vs. age 50-59, 51.5±16 vs. 46.3±13 mg,P< 0.0001). Of the 400 patients, 368 (92%) wanted to drive home or to their offices, and all did so without incident. A total of 99% were willing to repeat the same procedure again. CONCLUSIONS: Low-dose nurse-administered propofol sedation is safe and practical for diagnostic EGD.
Год издания: 2009
Авторы: Akira Horiuchi, Yoshiko Nakayama, Nao Hidaka, Yasuyuki Ichise, Masashi Kajiyama, Naoki Tanaka
Издательство: Lippincott Williams & Wilkins
Источник: The American Journal of Gastroenterology
Ключевые слова: Anesthesia and Sedative Agents, Airway Management and Intubation Techniques, Nausea and vomiting management
Другие ссылки: The American Journal of Gastroenterology (HTML)
PubMed (HTML)