Non-anesthesiologist-administered Propofol is not Related to an Increase in Transcutaneous CO 2 Pressure During Flexible Bronchoscopy Compared to Guideline-based Sedation: A Randomized Controlled Trial.

Autor: Mercado-Longoría R; Pulmonary and Critical Care Medicine Department, 'Dr. José E. González' University Hospital, Nuevo León Autonomous University, Monterrey, N.L., Mexico., Armeaga-Azoños C; Pulmonary and Critical Care Medicine Department, 'Dr. José E. González' University Hospital, Nuevo León Autonomous University, Monterrey, N.L., Mexico., Tapia-Orozco J; Pulmonary and Critical Care Medicine Department, 'Dr. José E. González' University Hospital, Nuevo León Autonomous University, Monterrey, N.L., Mexico., González-Aguirre JE; Pulmonary and Critical Care Medicine Department, 'Dr. José E. González' University Hospital, Nuevo León Autonomous University, Monterrey, N.L., Mexico. Electronic address: jeglza111@gmail.com.
Jazyk: English; Spanish; Castilian
Zdroj: Archivos de bronconeumologia [Arch Bronconeumol] 2017 Sep; Vol. 53 (9), pp. 489-494. Date of Electronic Publication: 2017 Apr 12.
DOI: 10.1016/j.arbres.2016.12.018
Abstrakt: Introduction: Evidence for the use of non-anesthesiologist-administered propofol for sedation during flexible bronchoscopy is scarce. The main objective of this study was to determine whether non-anesthesiologist-administered propofol balanced sedation was related to higher transcutaneous CO 2 pressure compared with current guideline-based sedation (combination midazolam and opioid). Secondary outcomes were post-procedural recuperation time, patient satisfaction and frequency of adverse events.
Methods: In this randomized controlled trial we included data from outpatients aged 18 years or older with an indication for flexible bronchoscopy in a university hospital in northern Mexico.
Results: Ninety-one patients were included: 42 in the midazolam group and 49 in the propofol group. During 60min of transcutaneous capnometry monitoring, mean transcutaneous CO 2 pressure values did not differ significantly between groups (43.6 [7.5] vs. 45.6 [9.6]mmHg, P=.281). Propofol was related with a high Aldrete score at 5, 10, and 15min after flexible bronchoscopy (9 [IQR 6-10] vs. 10 [9,10], P=.006; 9 [8-10] vs. 10 [IQR 10-10], P<.001 and 10 [IQR 9-10] vs. 10 [10], respectively) and with high patient satisfaction on a visual analogue scale of 1 (not satisfied) to 10 (very satisfied) (8.41 [1.25] vs. 8.97 [0.98], P=.03). Frequency of adverse events was similar among groups (30.9% vs. 22.4%, P=.47).
Conclusion: Compared with guideline-recommended sedation, non-anesthesiologist-administered propofol balanced sedation is not associated with higher transcutaneous CO 2 pressure or with more frequent adverse effects. Propofol use is associated with faster sedation recovery and with high patient satisfaction.
Clinical Trial Registration: NCT02820051.
(Copyright © 2017 SEPAR. Publicado por Elsevier España, S.L.U. All rights reserved.)
Databáze: MEDLINE
Externí odkaz: