Does the Use of Propofol Sedation Increase the Incidence of Post-ERCP Pancreatitis?

Fernandes, Alan Lins; Tieng, Andrea; Weinstein, Lenny; Jalal, Prasun K.; Stark, Bernard; Bank, Simmy

doi:10.1016/s0016-5107(05)01156-9

Cited by 1 publication

(1 citation statement)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…One study showed a protective effect of propofol compared to conventional sedation for the development of post-ERCP pancreatitis in univariate analysis and no effect in multivariate analysis [46]. No statistically significant difference was seen in patients who received propofol versus patients who received other sedating agents in two additional studies [47, 48]. Another study showed increased incidence of AP in patients sedated with propofol for esophagogastroduodenoscopy and ERCP ( P < 0.0001) [49].…”

Section: Discussionmentioning

confidence: 99%

Acute pancreatitis associated with intravenous administration of propofol: evaluation of causality in a systematic review of the literature

Haffar¹,

Kaur

Garg

et al. 2018

Gastroenterology Report

View full text Add to dashboard Cite

Acute pancreatitis (AP) associated with intravenous administration of propofol has been described with unknown causal relation. We therefore assessed this causality in a systematic review. Multiple databases were searched on 16 August 2017; studies were appraised and selected by two reviewers based on a priori criteria. Propofol causality was evaluated with the Naranjo scale and Badalov classification.We identified 18 studies from 11 countries with a total of 21 patients, and the majority had adequate methodological quality. The median age was 35 years (range, 4–77) and 10 (48%) were males. Overall, propofol was administrated in 8 patients as sedative along with induction/maintenance of anesthesia in 13 patients; median dose was 200 mg, with intermediate latency (1–30 days) in 14 (67%). Serum triglycerides were >1000 mg/dL in four patients. Severe AP was observed in four patients (19%). AP recurrence occurred in one out of two patients who underwent rechallenge. Mortality related to AP was 3/21(14%). Propofol was the probable cause of AP according to the Naranjo scale in 19 patients (89%).Propofol-induced AP has a probable causal relation and evidence supports Badalov class Ib. Hypertriglyceridemia is not the only mechanism by which propofol illicit AP. Propofol-induced AP was severe in 19% of patients with a mortality rate related to AP of 14%. Future research is needed to delineate whether this risk is higher if combined with other procedures that portend inherent risk of pancreatitis such as endoscopic retrograde cholangiopancreatography.

show abstract