Sedative effects of propofol and risk factors for excessive sedation in the endoscopic treatment of biliary and pancreatic diseases.

Autor: Maruki Y; Department of Hepatobiliary and Pancreatic Oncology National Cancer Center Hospital Tokyo Japan.; Molecular Oncology The Jikei University School of Medicine Tokyo Japan., Hijioka S; Department of Hepatobiliary and Pancreatic Oncology National Cancer Center Hospital Tokyo Japan., Yagi S; Department of Hepatobiliary and Pancreatic Oncology National Cancer Center Hospital Tokyo Japan., Takasaki T; Department of Hepatobiliary and Pancreatic Oncology National Cancer Center Hospital Tokyo Japan., Chatto M; Department of Hepatobiliary and Pancreatic Oncology National Cancer Center Hospital Tokyo Japan.; Department of Gastroenterology Makati Medical Center Makati City Philippines., Fukuda S; Department of Hepatobiliary and Pancreatic Oncology National Cancer Center Hospital Tokyo Japan., Yamashige D; Department of Hepatobiliary and Pancreatic Oncology National Cancer Center Hospital Tokyo Japan., Okamoto K; Department of Hepatobiliary and Pancreatic Oncology National Cancer Center Hospital Tokyo Japan., Agarie D; Department of Hepatobiliary and Pancreatic Oncology National Cancer Center Hospital Tokyo Japan., Hara H; Department of Hepatobiliary and Pancreatic Oncology National Cancer Center Hospital Tokyo Japan., Hagiwara Y; Department of Hepatobiliary and Pancreatic Oncology National Cancer Center Hospital Tokyo Japan., Nagashio Y; Department of Hepatobiliary and Pancreatic Oncology National Cancer Center Hospital Tokyo Japan., Morizane C; Department of Hepatobiliary and Pancreatic Oncology National Cancer Center Hospital Tokyo Japan., Sone M; Department of Diagnostic Radiology National Cancer Center Hospital Tokyo Japan., Okusaka T; Department of Hepatobiliary and Pancreatic Oncology National Cancer Center Hospital Tokyo Japan., Saito Y; Endoscopy Division National Cancer Center Hospital Tokyo Japan.
Jazyk: angličtina
Zdroj: DEN open 2024 Sep 02; Vol. 5 (1), pp. e417. Date of Electronic Publication: 2024 Sep 02 (Print Publication: 2025).
DOI: 10.1002/deo2.417
Abstrakt: Objectives: The safety and effectiveness of propofol in more complex endoscopic procedures, such as endoscopic retrograde cholangiopancreatography, remain unknown. Thus, we aimed to evaluate propofol sedation during endoscopic cholangiopancreatography, ultrasound-guided intervention, and gastroduodenal stenting and examine risk factors for excessive sedation.
Methods: We retrospectively analyzed data from 870 patients who underwent endoscopic treatment with propofol sedation for biliary and pancreatic disease between October 2020 and September 2021. Sedation included propofol and fentanyl, with continuous monitoring of vital signs and the bispectral index. The assessed risk factors included age, complications, body mass index, treatment duration, and specialty.
Results: Distal bile duct treatment ( n = 367), hilar bile duct treatment ( n = 197), post-small-intestinal reconstruction treatment ( n = 75), endoscopic ultrasound-guided intervention ( n = 140), and gastrointestinal obstruction treatment ( n = 91) were performed. The rates of excessive sedation, hypoxemia, and hypotension were 7.8%, 6.0%, and 1.8%, respectively. Post-small-intestinal reconstruction treatment had the highest incidence rate of excessive sedation (16%), whereas endoscopic ultrasound-guided intervention had the lowest incidence rate (4.3%). Multivariate analysis revealed significant associations between excessive sedation and comorbid sleep apnea, obesity, and prolonged procedural time.
Conclusions: Obesity, sleep apnea syndrome, and prolonged procedure time are risk factors for excessive sedation related to propofol use. Thus, sedation techniques should be tailored for these patients.
Competing Interests: None.
(© 2024 The Author(s). DEN Open published by John Wiley & Sons Australia, Ltd on behalf of Japan Gastroenterological Endoscopy Society.)
Databáze: MEDLINE
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