Tu1402 Sedation in Gastrointestinal Endoscopy: A Randomized Controlled Trial Comparing Nonanesthesiologist-Administered Propofol and Monitored Anesthesia Care

Paulo, Gustavo Andrade de; Martins, Fernanda P.; Macedo, Erika P.; Gonçalves, Manoel Ernesto Peçanha; Ferrari, Ângelo Paulo

doi:10.1016/j.gie.2011.03.894

Cited by 1 publication

(13 citation statements)

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“…This yielded 5 articles for inclusion [24][25][26][27][28] (Table 1). The designs of the studies included RCT (2 studies 26,28 ), prospective cohort (2 studies 24,25 ) and retrospective cohort (1 study 27 ). The median number of patients included in the studies was 1076 (range 90-17 611).…”

Section: Resultsmentioning

confidence: 99%

“…24,[26][27][28] In our pooled analysis, the odds of undergoing an airway intervention with NAAP were similar to those with AAP (OR 1.07, 95% CI 0.29 Records identi ed through database search n = 602…”

Section: Airway Interventionmentioning

confidence: 96%

“…The items were scored as 0 if not reported, 1 if reported but inadequate, and 2 if reported and adequate. Based on this score, nonrandomized trials were categorized as low risk of bias (score of 24), moderate risk (21)(22)(23)(24) and high risk (< 21).…”

Section: Quality and Risk Of Bias Assessmentmentioning

confidence: 99%

“…Three studies included only patients classified as American Society of Anesthesiologists (ASA) level I or II. 24,26,28 Nathan and colleagues 27 included a smaller proportion of patients classified as ASA III or IV in the NAAP group than in the AAP group (9% v. 67%) and none classified as ASA I in the AAP group. Vargo and colleagues 25 included patients in ASA categories I-IV and had comparable proportions in the NAAP and AAP groups.…”

Section: Baseline Characteristicsmentioning

confidence: 99%

“…The mortality rate was reported in 3 studies involving 20 687 patients 24,25,27 (Table 3). The only event was in the upper endoscopy NAAP group of Vargo and colleagues 25 (0.05%).…”

Section: Deathmentioning

confidence: 99%

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Propofol administration by endoscopists versus anesthesiologists in gastrointestinal endoscopy: a systematic review and meta-analysis of patient safety outcomes

Daza

Tan

Fielding

et al. 2018

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Background: With a growing demand for endoscopic services, the role of anesthesiologists in endoscopy units must be reassessed. The aim of this study was to compare patient outcomes in non-anesthesiologist-administered propofol (NAAP) versus anesthesiologist-administered propofol (AAP) during routine endoscopy. Methods:We systematically searched MEDLINE, CINAHL, Embase, Web of Science, CENTRAL and the grey literature for studies comparing NAAP and AAP. Primary outcomes included endoscopy-and sedation-related complications. Secondary outcomes included measures of endoscopy quality and of patient and endoscopist satisfaction. We reported treatment effects using random-effects models. Nonanesthesiologists administered lower propofol dosages than anesthesiologists (mean difference −61.79, 95% CI −114.46 to −9.12; 3443 patients), and their patients more commonly experienced awareness with recall (OR 19.99, 95% CI 7.88 to 50.76; 2090 patients). However, NAAP neither compromised patient willingness to repeat the procedure (OR 0.42, 95% CI 0.10 to 1.83; 2367 patients) nor lengthened total procedure time (mean difference −0.08, 95% CI −3.51 to 3.34; 2367 patients). Results Conclusion:Endoscopists may safely administer propofol without compromising procedural quality in patients classified as ASA I or II undergoing routine endoscopy. The results of this meta-analysis are limited by a lack of available high-quality studies. Further, large-scale studies are needed for definitive conclusions.Contexte : Étant donné que les services endoscopiques sont de plus en plus demandés, le rôle des anesthésiologistes dans les unités d'endoscopie doit être réévalué. Le but de cette étude était de comparer les résultats cliniques chez les patients selon que le propofol était administré par des non-anesthésiologistes (NAAP, pour nonanesthesiologist-administered propofol) ou par des anesthésiologistes (AAP, pour anesthesiologist-administered propofol).Méthodes : Nous avons procédé à une revue systématique des réseaux MEDLINE, CINAHL, Embase, Web of Science et CENTRAL et de la littérature grise pour recenser les études ayant comparé les méthodes NAAP et AAP. Les paramètres principaux incluaient les complications liées à l'endoscopie et à la sédation, et les paramètres secondaires incluaient les mesures de la qualité de l'endoscopie et la satisfaction des patients et des endoscopistes. Nous avons fait état des effets des traitements à l'aide de modèles à effets aléatoires.

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Section: Resultsmentioning

confidence: 99%

Section: Airway Interventionmentioning

confidence: 96%

Section: Quality and Risk Of Bias Assessmentmentioning

confidence: 99%

Section: Baseline Characteristicsmentioning

confidence: 99%

“…The mortality rate was reported in 3 studies involving 20 687 patients 24,25,27 (Table 3). The only event was in the upper endoscopy NAAP group of Vargo and colleagues 25 (0.05%).…”

Section: Deathmentioning

confidence: 99%

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