Risk Management for Sedation in Endoscopic Submucosal Dissection

Naruse, Mutsuko; Inatsuchi, Shuji

doi:10.1111/j.1443-1661.2007.00718.x

Cited by 5 publications

(2 citation statements)

References 8 publications

(13 reference statements)

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“…Sedation is commonly used to relieve anxiety and diminish pain, discomfort and memories of the procedure (6). In order to achieve these goals, we used pethidine hydrochloride, followed by midazolam when appropriate.…”

Section: Management During the Esd Proceduresmentioning

confidence: 99%

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Perioperative Complications of Endoscopic Submucosal Dissection for Early Gastric Cancer in Elderly Japanese Patients 75 Years of Age or Older

et al. 2015

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Objective The number of endoscopic submucosal dissection (ESD) procedures for early gastric cancers among patients 75 years of age or older has been increasing. We herein examined both the outcomes and complications of ESD in elderly patients. Methods We investigated the effects of underlying diseases, lesion characteristics, treatment outcomes and complications during and in the postoperative periods of ESD among elderly patients 75 years of age or older versus non-elderly patients less than 75 years of age. Patients A total of 318 early gastric cancers in consecutive 307 patients, all of whom underwent ESD for gastric cancer, were included in this study. Results The number of patients with hypertension and ischemic heart disease was significantly higher in the elderly group than in the non-elderly group. The proportion of lesions with an absolute indication, extended indication or no indication was not significantly different between the groups. During the ESD procedure, the use of atropine sulfate for bradycardia was significantly more frequent in the elderly group. No significant differences were observed between the groups in terms of the treatment for hypertension, oxygen administration or incidence of perforation. In addition, there were no significant differences with respect to oxygen administration, postoperative bleeding or the occurrence of fever and/or pneumonia after the ESD procedure. Conclusion Although bradycardia was more frequently observed in the elderly patients during ESD in this study, ESD was performed safely and managed appropriately, with infrequent postoperative complications. ESD appears to be effective, even in elderly patients.

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Section: Management During the Esd Proceduresmentioning

confidence: 99%

“…However, ESD has a number of disadvantages, including the need for a high level of technical skill, a long operative time and a high frequency of complications (3)(4)(5). Therefore, reducing body movements with sedation is important for performing a safe and successful ESD procedure (6).…”

Section: Introductionmentioning

confidence: 99%

Perioperative Complications of Endoscopic Submucosal Dissection for Early Gastric Cancer in Elderly Japanese Patients 75 Years of Age or Older

et al. 2015

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Salivary amylase activity is useful for assessing perioperative stress in response to pain in patients undergoing endoscopic submucosal dissection of gastric tumors under deep sedation

et al. 2010

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Comparison of Postoperative Complications after Endoscopic Submucosal Dissection: Differences of Insufflations and Anesthesias

Mori

Kobara

Muramatsu

et al. 2011

Diagnostic and Therapeutic Endoscopy

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Endoscopic submucosal dissection (ESD) has enabled the collective resection and increased the accuracy of pathological diagnosis. However, ESD requires a long operation time, which results in increased doses of analgesics/sedatives, and causes worsening of respiratory and hemodynamic statuses. To reduce postoperative complications, we have applied ESD with CO2 insufflation and general anesthesia. This study included 50 patients who underwent ESD for early gastric cancer, 25 with air insufflation and intravenous anesthesia (Air/IV group), and the remaining 25 with CO2 insufflation and general anesthesia (CO2/GA group). Postoperative enlarged feeling of the abdomen was observed only in 1 of 25 patients in the CO2/GA group (P = 0.0416). Postoperative severe unrest was observed in none of the patients in the CO2/GA group and in 4 of 25 (16%) patients in the Air/IV group (P = 0.0371). CO2 insufflation and general anesthesia are useful in stabilizing intraoperative conditions and reducing postoperative complications.

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Risk Management for Sedation in Endoscopic Submucosal Dissection

Cited by 5 publications

References 8 publications

Perioperative Complications of Endoscopic Submucosal Dissection for Early Gastric Cancer in Elderly Japanese Patients 75 Years of Age or Older

Perioperative Complications of Endoscopic Submucosal Dissection for Early Gastric Cancer in Elderly Japanese Patients 75 Years of Age or Older

Salivary amylase activity is useful for assessing perioperative stress in response to pain in patients undergoing endoscopic submucosal dissection of gastric tumors under deep sedation

Comparison of Postoperative Complications after Endoscopic Submucosal Dissection: Differences of Insufflations and Anesthesias

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