Clinical analysis of propofol deep sedation for 1,104 patients undergoing gastrointestinal endoscopic procedures: A three year prospective study

Gašparović, Stojanka; Rustemović, Nadan; Opačić, Milorad; Premužić, Marina; Korušić, Anđelko; Božikov, Jadranka; Bates, Tamara

doi:10.3748/wjg.v12.i2.327

Cited by 52 publications

(43 citation statements)

References 25 publications

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“…Its rapid onset of action and amnesic properties, coupled with smooth and rapid recovery, make propofol an appealing agent for procedural sedation [11,17,18]. The significant advantage of a faster recovery time compared with other sedatives has been emphasised in several studies [19][20][21][22]. However, as yet, there are only limited data evaluating propofol for flexible bronchoscopy and it is as yet unknown whether the combination of propofol and an opiate offers any advantage over propofol alone for sedation during flexible bronchoscopy.…”

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confidence: 98%

Propofol versus propofol plus hydrocodone for flexible bronchoscopy: a randomised study

Schlatter¹,

Pflimlin²,

Fehrke³

et al. 2011

European Respiratory Journal

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Propofol and the combination of a benzodiazepine and an opiate have been established for sedation in flexible bronchoscopy. It is as yet unknown whether propofol in combination with an opiate is superior to propofol alone to suppress cough during the procedure. 300 consecutive patients undergoing flexible bronchoscopy at a tertiary care university hospital were randomly allocated to receive either the combination propofol and hydrocodone or propofol alone in a double-blind fashion. The primary end-point was the cough score during the procedure as estimated by the physician using a visual analogue scale.Demographics were similar in both groups. Compared with propofol alone, median (interquartile range) cough scores assessed by physicians, nurses and patients were significantly lower in the group randomised to the combination propofol and hydrocodone (2.5 (1.5-4.0) versus 2.0 (1.0-3.0), respectively, p50.011). Additionally, patients receiving the combination required significantly lower doses of propofol than those receiving propofol alone (200 mg (140-280) versus 260 mg (180-350), p,0.0001). Complex examinations, including bronchoalveolar lavage or transbronchial biopsy, benefited more from additional opiate. The duration of the procedure, time to discharge and complication rate were similar in both groups.The combination of propofol and hydrocodone is safe and superior to propofol alone for cough suppression in flexible bronchoscopy.

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mentioning

confidence: 98%

Propofol versus propofol plus hydrocodone for flexible bronchoscopy: a randomised study

Schlatter¹,

Pflimlin²,

Fehrke³

et al. 2011

European Respiratory Journal

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“…Its rapid onset of action and amnesic properties, coupled with smooth and rapid recovery, make propofol an appealing agent for procedural sedation [16,17]. The significant advantage of a faster recovery time, as compared to other sedatives, has been emphasised in several studies [9,[18][19][20]. However, to date, there are only limited data evaluating propofol for flexible bronchoscopy and no safety data comparing propofol with combined sedation in this setting.…”

mentioning

confidence: 98%

Propofol versus combined sedation in flexible bronchoscopy: a randomised non-inferiority trial

Stolz¹,

Kurer²,

Meyer³

et al. 2009

European Respiratory Journal

108

115

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Combined sedation with a benzodiazepine and an opiate has been proposed as standard sedation for bronchoscopy. Propofol is a sedative-hypnotic with a rapid onset of action and fast recovery time, but carries the potential risk of respiratory failure.Consecutive patients (n5200) were randomly allocated to receive either the combination midazolam and hydrocodone or intravenous propofol. The primary end-points were the mean lowest arterial oxygen saturation during bronchoscopy and the readiness-for-discharge score 1 h after the procedure.The mean lowest arterial oxygen saturation during bronchoscopy did not differ across treatment groups (p50.422), and the number of patients recording an arterial oxygen saturation of f90% on at least one occasion was similar in both groups (p50.273). The median (interquartile range) readiness-for-discharge score 1 h after the procedure was significantly higher in the propofol group than in the combined sedation group (8 (6-9) versus 7 (5-9); p50.035). Patients assigned propofol exhibited less tachycardia during bronchoscopy and for o1 h after the examination. Minor procedural complications were noted in 71 (35.5%) patients and exhibited a similar incidence in both treatment arms (p50.460).Propofol is as effective and safe as combined sedation in patients undergoing flexible bronchoscopy, thus representing an appealing option if timely discharge is a priority.

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“…The amount of sedation required depends on the patient's physical status and age. Propofol is widely employed for anesthesia outside the OR because it is easy to use, has a good safety and efficacy profile due to its quick onset of action, rapid metabolism, significantly shorter recovery time and it has some anti-emetic effects [12][13][14].…”

Section: Discussionmentioning

confidence: 99%

Propofol-Based Deep Sedation for Percutaneous Radiofrequency Ablation in Sick Elderly Patients with Hepatocellular Carcinoma in a Developing Country

2017

JACCOA

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The aim of this study was to evaluate and compare the clinical efficacy of propofol-based deep sedation (PBDS) for percutaneous radiofrequency ablation (RFA) in sick (American Society of Anesthesiologists [ASA] physical status III-IV) and nonsick (ASA physical status I-II) elderly patients in a teaching hospital in Thailand. We undertook a retrospective review of the sedation service records of elderly patients who underwent RFA procedures from 2010 to 2012. Patients were classified into two groups according to ASA physical status. In group A, patients had ASA I-II, while in group B, patients had ASA III-IV. Primary outcome variable was the successful completion of procedure. Secondary outcome variables were sedation-related complications during and immediately after procedure. There were 113 elderly patients who underwent RFA procedures by using PBDS during the study period. Of these, 69 patients were in group A and 44 patients were in group B. There were no significant differences in age, weight, duration of sedation, and mean dose of propofol, fentanyl, and midazolam between the two groups. All procedures in both groups were successfully completed. Overall and cardiorespiratory-related complications in both groups were not significantly different. All sedation-related complications were easily treated, with no adverse sequelae. PBDS for percutaneous RFA in sick elderly patients by trained anesthetic personnel with appropriate monitoring was safe and effective. The clinical efficacy of this technique in sick elderly patients was not different or worse than in nonsick elderly patients. Serious complications were rare.

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Clinical analysis of propofol deep sedation for 1,104 patients undergoing gastrointestinal endoscopic procedures: A three year prospective study

Abstract: Our results showed that propofol provided good sedation with excellent pain control, a short recovery time and no significant hemodynamic side effects if carefully titrated. All the patients (and especially ASA III group) require monitoring and care of an anesthesiologist.

Cited by 52 publications

References 25 publications

Propofol versus propofol plus hydrocodone for flexible bronchoscopy: a randomised study

Propofol versus propofol plus hydrocodone for flexible bronchoscopy: a randomised study

Propofol versus combined sedation in flexible bronchoscopy: a randomised non-inferiority trial

Propofol-Based Deep Sedation for Percutaneous Radiofrequency Ablation in Sick Elderly Patients with Hepatocellular Carcinoma in a Developing Country

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