Propofol-Based Sedation in Gastrointestinal Endoscopy: Getting Safer and Safer

Schilling, Dieter

doi:10.1159/000362541

Cited by 4 publications

(4 citation statements)

References 12 publications

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“…In this context, our work may prove valuable for high‐risk patients who received propofol for maintenance of general anesthesia or for deep sedation in intensive care unit and day case surgery or procedures (Landoni et al . ; Schilling ). Second, one can argue that the use of an ‘extra’ anesthetic propofol could induce more depth of anesthesia and hence reduce cerebral oxygen consumption further for better outcome but this is just an assumption and warrants further study.…”

Section: Discussionmentioning

confidence: 99%

Inhibition of microglial activation contributes to propofol‐induced protection against post‐cardiac arrest brain injury in rats

Wang

Ling

Feng

et al. 2015

Journal of Neurochemistry

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It has been suggested that propofol can modulate microglial activity and hence may have potential roles against neuroinflammation following brain ischemic insult. However, whether and how propofol can inhibit post-cardiac arrest brain injury via inhibition of microglia activation remains unclear. A rat model of asphyxia cardiac arrest (CA) was created followed by cardiopulmonary resuscitation. CA induced marked microglial activation in the hippocampal CA1 region, revealed by increased OX42 and P2 class of purinoceptor 7 (P2X7R) expression, as well as p38 MAPK phosphorylation. Morris water maze showed that learning and memory deficits following CA could be inhibited or alleviated by pre-treatment with the microglial inhibitor minocycline or propofol. Microglial activation was significantly suppressed likely via the P2X7R/ p-p38 pathway by propofol. Moreover, hippocampal neuronal injuries after CA were remarkably attenuated by propofol. In vitro experiment showed that propofol pre-treatment inhibited ATP-induced microglial activation and release of tumor necrosis factor-a and interleukin-1b. In addition, propofol protected neurons from injury when co-culturing with ATPtreated microglia. Our data suggest that propofol pre-treatment inhibits CA-induced microglial activation and neuronal injury in the hippocampus and ultimately improves cognitive function.

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Section: Discussionmentioning

confidence: 99%

Inhibition of microglial activation contributes to propofol‐induced protection against post‐cardiac arrest brain injury in rats

Wang

Ling

Feng

et al. 2015

Journal of Neurochemistry

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“…Propofol is an often chosen agent for endoscopic sedation (32). It has been reported that the risk of complications, including aspiration pneumonia during colonoscopies, is lower under propofol sedation than under other sedation methods (33).…”

Section: Discussionmentioning

confidence: 99%

Effects of alfentanil or fentanyl added to propofol for sedation in colonoscopy on cognitive functions: Randomized controlled trial

Doğanay

Ekmekçi²,

Kazbek³

et al. 2017

Turk J Gastroenterol

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“…Indeed, patients under sedation during diagnostic or therapeutic endoscopic procedures generally experience minimal or even no discomfort[ 4 , 5 ]. Numerous studies have evaluated the efficacy and safety of anesthetics for sedation colonoscopy, such as propofol, which is a short-acting rapid-recovering anesthetic[ 6 - 12 ]. The results of previous studies suggest that propofol, particularly delivered by target-controlled infusion (TCI), which is a drug delivery technique applied to achieve the desired anesthetic drug concentration by using a pharmacokinetic model and considering the patient characteristics [ i.e., age, gender and body mass index (BMI)], is an effective anesthetic with rapid onset and short recovery[ 11 , 13 - 18 ].…”

Section: Introductionmentioning

confidence: 99%

Efficacy and safety of propofol target-controlled infusion combined with butorphanol for sedated colonoscopy

Guo¹,

Sun²,

Feng³

et al. 2023

World J Clin Cases

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BACKGROUND Propofol is a short-acting, rapid-recovering anesthetic widely used in sedated colonoscopy for the early detection, diagnosis and treatment of colon diseases. However, the use of propofol alone may require high doses to achieve the induction of anesthesia in sedated colonoscopy, which has been associated with anesthesia-related adverse events (AEs), including hypoxemia, sinus bradycardia, and hypotension. Therefore, propofol co-administrated with other anesthetics has been proposed to reduce the required dose of propofol, enhance the efficacy, and improve the satisfaction of patients receiving colonoscopy under sedation. AIM To evaluate the efficacy and safety of propofol target-controlled infusion (TCI) in combination with butorphanol for sedation during colonoscopy. METHODS In this controlled clinical trial, a total of 106 patients, who were scheduled for sedated colonoscopy, were prospectively recruited and assigned into three groups to receive different doses of butorphanol before propofol TCI: Low-dose butorphanol group (5 μg/kg, group B1), high-dose butorphanol group (10 μg/kg, group B2), and control group (normal saline, group C). Anesthesia was achieved by propofol TCI. The primary outcome was the median effective concentration (EC50) of propofol TCI, which was measured using the up-and-down sequential method. The secondary outcomes included AEs in perianesthesia and recovery characteristics. RESULTS The EC50 of propofol for TCI was 3.03 μg/mL [95% confidence interval (CI): 2.83-3.23 μg/mL] in group B2, 3.41 μg/mL (95%CI: 3.20-3.62 μg/mL) in group B1, and 4.05 μg/mL (95%CI: 3.78-4.34 μg/mL) in group C. The amount of propofol necessary for anesthesia was 132 mg [interquartile range (IQR), 125-144.75 mg] in group B2 and 142 mg (IQR, 135-154 mg) in group B1. Furthermore, the awakening concentration was 1.1 μg/mL (IQR, 0.9-1.2 μg/mL) in group B2 and 1.2 μg/mL (IQR, 1.025-1.5 μg/mL) in group B1. Notably, the propofol TCI plus butorphanol groups (groups B1 and B2) had a lower incidence of anesthesia AEs, when compared to group C. Furthermore, no significant differences were observed in the rates of AEs in perianesthesia, including hypoxemia, sinus bradycardia, hypotension, nausea and vomiting, and vertigo, among group C, group B1 and group B2. CONCLUSION The combined use with butorphanol reduces the EC50 of propofol TCI for anesthesia. The decrease in propofol might contribute to the reduced anesthesia-related AEs in patients undergoing sedated colonoscopy.

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Propofol-Based Sedation in Gastrointestinal Endoscopy: Getting Safer and Safer

Cited by 4 publications

References 12 publications

Inhibition of microglial activation contributes to propofol‐induced protection against post‐cardiac arrest brain injury in rats

Inhibition of microglial activation contributes to propofol‐induced protection against post‐cardiac arrest brain injury in rats

Effects of alfentanil or fentanyl added to propofol for sedation in colonoscopy on cognitive functions: Randomized controlled trial

Efficacy and safety of propofol target-controlled infusion combined with butorphanol for sedated colonoscopy

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