Mo1257 Deep Sedation Events During Diagnostic Upper Gastrointestinal Endoscopy: A Randomized Study of the Regimens Propofol-Fentanyl and Midazolam-Fentanyl

Polymorphism rs4263535 in GABRA1 intron 4 was related to deeper sedation by intravenous midazolam

“…[1][2][3] Instead, benzodiazepines potentiate the inhibitory action of GABA by increasing the flow of chloride ions through ion channels, which reduces the ability of the affected cell to generate an action potential. 7 The hypnotic effect of midazolam is known to be associated with The rs4263535 polymorphism was associated with the lowest BIS during sedation induction (P ¼ 0.025; Kruskal-Wallis test); and multiple comparisons for the rs4263535 polymorphism showed significant median differences in the lowest BIS measured during induction between patients with A/A and G/G rs4263535 genotypes (P ¼ 0.042; Mann-Whitney U-test). P-values for multiple comparisons were corrected with the Bonferroni correction to account for the number of comparisons.…”

“…More recently developed BIS methodology has provided an additional means of assessing the level of consciousness of a patient: the BIS is regarded as a valuable addition to the clinician's repertoire of methods for monitoring the level of consciousness in patients undergoing midazolam sedation. [7][8][9][10]15 BIS monitoring provides an objective real-time measurement of the depth of anaesthesia via a weighted sum of electroencephalographic subparameters that are transformed into numeric values ranging from 0 (no electrical activity in the brain) to 100 (fully conscious). As the state of consciousness evolves from awake to sedated, or exhibits burst suppression, the BIS decreases.…”

“…1 Comparative studies have shown that midazolam at a dose of 0.05-0.12 mg/kg produces satisfactory sedation and operating conditions as effectively as the administration of 0.06-0.2 mg/kg diazepam in patients undergoing gastroscopy, dental implantation, cataract surgery or spinal anaesthesia. [2][3][4][5][6][7][8][9][10] Compared with diazepam, the onset of action of midazolam is usually more rapid and the degree of amnesia is greater, but the speed of onset of the effect of midazolam without premedication varies between individuals. 11 Although this inter-individual variability is reduced at higher doses of the drug, 4 these differences reduce the predictability of sedation induction using midazolam.…”

Intravenous Sedation Techniques for Gastrointestinal Endoscopy

“…The authors concluded that deep sedation frequently occurred with the combination of propofol and fentanyl. However, recovery was faster in the propofol-fentanyl group [28] . Most of the ERCP procedures can be performed by using moderate sedation technique.…”

¿Existe un valor de índice biespectral adecuado para endoscopias digestivas altas en respiración espontánea en el paciente pediátrico?

“…En adultos, aunque hay más estudios [18][19][20] , los valores de BIS para permitir realizar una EDA en respiración espontánea y con sensación de bienestar del paciente son mayores: solo el 7% de los pacientes de Lera dos Santos et al 18 precisan un BIS menor de 65; el valor medio de BIS en el trabajo de Jang et al 20 para realizar colangiopancreatoradiografía endoscópica (CPRE) es de 76,5.…”