Changing Patterns of Sedation and Monitoring Practice during Endoscopy: Results of a Nationwide Survey in Switzerland

Heuss, Ludwig T.; Froehlich, Florian; Beglinger, C

doi:10.1055/s-2004-826143

Cited by 150 publications

(135 citation statements)

References 15 publications

Supporting

Mentioning

113

Contrasting

Unclassified

Order By: Relevance

“…Based on the findings of the present study, no specific trend was observed in the association between peak Pc,CO 2 and change in Pc,CO 2 with procedure duration, both a short and a longer procedure duration were associated with the peak Pc,CO 2 and change in Pc,CO 2 . The ability to effectively measure Pc,CO 2 is an important step in patient monitoring as diagnostic bronchoscopies are performed using routine sedation and also drugs, such as propofol, which are considered as general anaesthetics are being increasingly used also in the absence of a trained anaesthetist [16][17][18][19].…”

Section: Discussionmentioning

confidence: 99%

Measurement of combined oximetry and cutaneous capnography during flexible bronchoscopy

Chhajed

Rajasekaran²,

Kaegi³

et al. 2006

European Respiratory Journal

View full text Add to dashboard Cite

The aim of the present study was to assess the feasibility of measuring combined arterial oxygen saturation measured by pulse oximetry (Sp,O 2 ) and cutaneous carbon dioxide tension (Pc,CO 2 ) to monitor ventilation and quantify change in Pc,CO 2 during bronchoscopy.Combined Sp,O 2 and Pc,CO 2 were measured at the ear lobe in 114 patients. In four patients, the ear-clip slipped and they were excluded. In total, 11 patients had artefacts with Sp,O 2 recordings, thus, Sp,O 2 was analysed in 99 patients. Spirometry data were available in 77 patients. Multivariate analysis of covariance and logistic regression were used for statistical analyses.Mean baseline Pc,CO 2 was 4.78¡1.06 kPa (36¡8 mmHg) and mean rise in the Pc,CO 2 during bronchoscopy was 1.26¡0.70 kPa (9.5¡5.3 mmHg), while mean Pc,CO 2 at the end of bronchoscopy was 5.85¡1.19 kPa (44¡9 mmHg) . Baseline Pc,CO 2 and the lowest Sp,O 2 were significantly associated with peak Pc,CO 2 and the change in Pc,CO 2 during bronchoscopy. Risk of significant hypoxaemia (Sp,O 2 f90%) was lower for a higher baseline Sp,O 2 . Peak Pc,CO 2 was directly associated with significant hypoxaemia. There was no significant association in the baseline Pc,CO 2 , peak Pc,CO 2 , baseline Sp,O 2 or the lowest Sp,O 2 comparing patients with and without chronic obstructive pulmonary disease.In conclusion, it is feasible to measure combined pulse oximetry and cutaneous carbon dioxide tension effectively to monitor ventilation during flexible bronchoscopy.

show abstract

Section: Discussionmentioning

confidence: 99%

Measurement of combined oximetry and cutaneous capnography during flexible bronchoscopy

Chhajed

Rajasekaran²,

Kaegi³

et al. 2006

European Respiratory Journal

View full text Add to dashboard Cite

show abstract

“…Conventional sedation with benzodiazepines and opioids is being replaced by the use of propofol (1), as a single agent or in combination with standard sedatives, due to its ultrashort onset of action, its short plasma half-life and the faster recovery from sedation (2). This property makes it the ideal agent for use in ambulatory endosocopy, as it reduces post procedure surveillance (3)(4)(5).…”

Section: Introductionmentioning

confidence: 99%

Endoscopist controlled administration of propofol: an effective and safe method of sedation in endoscopic procedures

Sáenz-López

Muñoz

Rodríguez‐Alcalde

et al. 2006

Rev. esp. enferm. dig.

View full text Add to dashboard Cite

Objectives: propofol is a short-acting, hypnotic agent that is increasingly being used for gastrointestinal endoscopic sedation. There are concerns about the use of propofol by non anesthesiologists due to its potential for respiratory and cardiovascular depression. This report describes our experience concerning effectiveness and safety of propofol administered in endoscopic procedures by the endoscopist and the assistant nurse.Methods: in this prospective study, a total of 102 consecutive endoscopies (60 colonoscopies and 42 upper endoscopies) performed under sedation with propofol were included. In 27 (26.47%) endoscopies propofol was administered alone and in 75 endoscopies (73.53%) it was combined with benzodiazepines and/or opioids. Seventy-six (74.51%) endoscopies were performed in patients under 65 years of age and 26 (25.49%) in patients over 65 years of age. Ninety-one (89.22%) endoscopies were performed in patients with low surgical risk (ASA I-II) and 11 (10.78%) in patients with high surgical risk. The medication was administered by the endoscopist that performed the procedure and the assistant nurse.Results: the mean dose of propofol used was 72.14 mg for gastroscopies and 71.33 for colonoscopies (p = 0.92). The mean dose of propofol when infused alone was 84.81 mg whereas in combination with benzodiazepines/opioids was 66.93 mg (p = 0.06). The doses of propofol required were lower for those colonoscopies in which midazolam and/or meperidine was combined and in patients over 65 years of age (p = 0.006 y p = 0.001, respectively). Eleven (10.8%) minor complications were reported, and managed by the own endoscopist. Patients had no memories of the procedure. The tolerance rated by the endoscopist was excellent-good, fair, bad-very bad in 83, 5 and 12% of the gastroscopies and in 79, 8 and 13% of the colonoscopies respectively. Nevertheless bad tolerance did not hinder the completion of the procedure in any case.Conclusions: the administration of propofol by the endoscopist and the assistant nurse, is an effective and safe method of sedation in patients of low and high-risk as well as in elderly patients. The doses of propofol required for an adequate sedation were lower in patients over 65 years of age and for colonoscopies in which medication was combined.

show abstract

“…Due to its rapid recovery profile, the use of propofol has increased for many endoscopic procedures over the last decade [10][11][12][13][14]. Propofol produces safe, effective, and well-tolerated sedation [15].…”

Section: Discussionmentioning

confidence: 99%

Continuous propofol and bolus propofol result in similar sedative use during endoscopic retrograde cholangiopancreatography: A retrospective study

Seyitoglu¹,

İskender²,

Azzarok³

et al. 2017

Gastroenterol Hepatol Endosc

View full text Add to dashboard Cite

show abstract

Changing Patterns of Sedation and Monitoring Practice during Endoscopy: Results of a Nationwide Survey in Switzerland

Abstract: The use of sedation in gastrointestinal endoscopy has markedly increased over the last 13 years and the use of electronic monitoring has become standard practice. A significant percentage of Swiss gastroenterologists report that they use propofol, mainly in a hospital setting.

Cited by 150 publications

References 15 publications

Measurement of combined oximetry and cutaneous capnography during flexible bronchoscopy

Measurement of combined oximetry and cutaneous capnography during flexible bronchoscopy

Endoscopist controlled administration of propofol: an effective and safe method of sedation in endoscopic procedures

Continuous propofol and bolus propofol result in similar sedative use during endoscopic retrograde cholangiopancreatography: A retrospective study

Contact Info

Product

Resources

About