Role of combined propofol and sufentanil anesthesia in endoscopic injection sclerotherapy for esophageal varices

Abstract

AIMTo investigate the efficacy and safety of a combination of sufentanil and propofol injection in patients undergoing endoscopic injection sclerotherapy (EIS) for esophageal varices (EVs).METHODSPatients with severe EVs who underwent EIS with sufentanil and propofol anesthesia between April 2016 and July 2016 at our hospital were reviewed. Although EIS and sequential therapy were performed under endotracheal intubation, we only evaluated the efficacy and safety of anesthesia for the first EIS procedure. Patients were intravenously treated with 0.5-1 μg/kg sufentanil. Anesthesia was induced with 1-2 mg/kg propofol and maintained using 2-5 mg/kg per hour of propofol. Information, regarding age, sex, weight, American Association of Anesthesiologists (ASA) physical status, Child-Turcotte-Pugh (CTP) classification, indications, preanesthetic problems, endoscopic procedure, successful completion of the procedure, anesthesia time, recovery time, and anesthetic agents, was recorded. Adverse events, including hypotension, hypertension, bradycardia, and hypoxia, were also noted.RESULTSPropofol and sufentanil anesthesia was provided in 182 procedures involving 140 men and 42 women aged 56.1 ± 11.7 years (range, 25-83 years). The patients weighed 71.4 ± 10.7 kg (range, 45-95 kg) and had ASA physical status classifications of II (79 patients) or III (103 patients). Ninety-five patients had a CTP classification of A and 87 had a CTP classification of B. Intravenous anesthesia was successful in all cases. The mean anesthesia time was 33.1 ± 5.8 min. The mean recovery time was 12.3 ± 3.7 min. Hypotension occurred in two patients (1.1%, 2/182). No patient showed hypertension during the endoscopic therapy procedure. Bradycardia occurred in one patient (0.5%, 1/182), and hypoxia occurred in one patient (0.5%, 1/182). All complications were easily treated with no adverse sequelae. All endoscopic procedures were completed successfully.CONCLUSIONThe combined use of propofol and sufentanil injection in endotracheal intubation-assisted EIS for EVs is effective and safe.

Safety and tolerability of esketamine in propofol based sedation for endoscopic variceal ligation with or without injection sclerotherapy: Randomized controlled trial

“…According to the group allocation, the patients in four groups were respectively sedated using propofol 1.5 mg/kg and sufentanil 0.1 μg/kg (group S), propofol 1.5 mg/kg and esketamine 0.2 mg/kg (group E0.2), propofol 1.5 mg/kg and esketamine 0.3 mg/kg (group E0.3), and propofol 1.5 mg/kg and esketamine 0.4 mg/kg (group E0.4). The dosage of propofol and sufentanil was determined according to the Chinese endoscopic guideline 16 and previous studies 17–19 . Esketamine or sulfentanil were prepared according to bodyweight and diluted with normal saline into a 10 mL syringe, then given to the patient 2 min before propofol.…”

“…The dosage of propofol and sufentanil was determined according to the Chinese endoscopic guideline 16 and previous studies. [17][18][19] Esketamine or sulfentanil were prepared according to bodyweight and diluted with normal saline into a 10 mL syringe, then given to the patient 2 min before propofol. Additional propofol 0.5 mg/kg was added to keep patients within target sedation level.…”

ED50 of propofol in combination with low‐dose sufentanil for intravenous anaesthesia in hysteroscopy

“…The combined use of propofol and sufentanil injection for intravenous anaesthesia in endotracheal intubation-assisted endoscopic injection sclerotherapy for oesophageal varices has been demonstrated to be effective and safe, 4 when performed with 0.5-1 μg/kg sufentanil, an induction dose of 1-2 mg/kg propofol and a maintenance dose of 2-5 mg/kg propofol per hour.…”

“…With the development of assisted reproductive technology and minimally invasive technique, hysteroscopy under intravenous anaesthesia has become increasingly popular in gynaecology . Given its favourable sedative effect, wide range of inhibitory effects on the central nervous system, and rapid onset and short duration of action, the combination of propofol and opioids for intravenous anaesthesia is commonly used in clinical anaesthesiology . However, the minimal effective dosage of propofol when administered in combination with low‐dose sufentanil is unknown, and few clinical studies of sufentanil for hysteroscopy exist.…”

Different Doses of Oxycodone for Endoscopic Injection Sclerotherapy of Esophageal Varices

“…Because patients with it often have impaired liver function, however, normal doses of sedatives and opioids can cause serious adverse effects [ 1 – 3 ]. Nevertheless, during EIS, good immobilization of patients is required, which necessitates relatively deep analgesia and sedation [ 4 ]. As a dual opioid receptor agonist, oxycodone has complete affinity for the μ-opioid receptor and a lower affinity for the κ-opioid receptor.…”