Hot Topics in Airway Management During Gastrointestinal Endoscopy

Torino, Annarita; Martino, Daniela Di; Fusco, Pierluigi; Collina, Umberto; L, Marullo; Ferraro, Fausto

doi:10.4172/2161-069x.1000377

Cited by 6 publications

(4 citation statements)

References 24 publications

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“…Therefore, to choose the sedation stage, it is necessary to consider patient-dependent, procedure-dependent variables ( 33 ) and operator-dependent variables. Generally, quick and easy diagnostic and therapeutic procedures such as PEG-J are easily performed in moderate sedation ( 34 ).…”

Section: Discussionmentioning

confidence: 99%

“…In our opinion, sedation during a PEG-J implant procedure is an indispensable element as much for the proper technical success of the process (although relatively safe, it requires several endoscopic and no endoscopic steps) as for the safety and well-being of the patient undergoing it. In addition, however, such a procedure, when framed in the context of patients with neurological comorbidity such as PD, places an even greater need on the anesthesiologists and endoscopists to follow a tailored approach to maintain a good depth of moderate sedation while avoiding the additional risks of general anesthesia ( 34 ).…”

Section: Discussionmentioning

confidence: 99%

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Effectiveness and safety of an atropine/midazolam and target controlled infusion propofol-based moderate sedation protocol during percutaneous endoscopic transgastric jejunostomy procedures in Parkinson’s disease: a real-life retrospective observational study

Gravina,

Pellegrino,

De Micco

et al. 2023

Front. Med.

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Patients with Parkinson’s disease (PD), often elderly with various comorbidities, may require a continuous intestinal infusion of carbidopa/levodopa gel by the placement of a percutaneous endoscopic gastrostomy (PEG) with a jejunal tube (PEG-J) to improve their motor outcome and quality of life. However, it is unclear what is the best procedural sedation protocol for PEG-J procedures. Fifty patients with PD and indication for PEG-J procedure (implantation, replacement, removal) underwent, from 2017 to 2022, a sedation protocol characterized by premedication with atropine (0.01 mg/Kg i.v.), midazolam (0.015–0.03 mg/Kg i.v.) and induction with bolus propofol (0.5–1 mg/Kg i.v.) as well as, finally, sedation with continuous infusion propofol (2–5 mg/Kg/h i.v.) by Target Controlled Infusion (TCI) technique. Ninety-eight per cent of patients experienced no intraprocedural or peri-procedural adverse events. All the procedures were technically successful. A good discharge time was recorded. The vital parameters recorded during the procedure did not vary significantly. A PEG-J procedure conducted within 30 min showed a significant advantage over end-tidal carbon dioxide (EtCO2). Indeed, the latter showed some predictive behavior (OR: 1.318, 95% CI 1.075–1.615, p = 0.008). In the real world, this sedation protocol showed a good safety and effectiveness profile, even with reduced doses of midazolam and a TCI propofol technique in moderate sedation.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Effectiveness and safety of an atropine/midazolam and target controlled infusion propofol-based moderate sedation protocol during percutaneous endoscopic transgastric jejunostomy procedures in Parkinson’s disease: a real-life retrospective observational study

Gravina,

Pellegrino,

De Micco

et al. 2023

Front. Med.

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“…For many years, we have been using the Endoscopy Mask (VBM Medizintechnik GmbH, Sulz, Germany) to administer gas anesthesia (sevoflurane), mainly to pediatric patients [3]. Its cushion inflation valve easily adapts to the patient's face and it also has a connector in the inferior part of the mask for inhalational anesthetic drugs.…”

mentioning

confidence: 99%

“…There are also at least two other products, the Endoscopy Mask (DEAS, Italy) [3] and the Intersurgical Explorer Endoscopy Mask (Intersurgical Wokingham, RG41 2RZ, UK) [4] that have similar characteristics and have proven to be safe for upper endoscopy.…”

mentioning

confidence: 99%