Safety and Effectiveness of Nurse-Administered Propofol Sedation in Outpatients Undergoing Gastrointestinal Endoscopy
| Autor: | Masamichi Sato, Akira Horiuchi, Masashi Kajiyama, Michio Tamaki, Yasuyuki Ichise, Yuta Yamamoto, Naoki Tanaka |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Adult
Male Cost effectiveness Sedation Colonoscopy Endoscopy Gastrointestinal 03 medical and health sciences Young Adult 0302 clinical medicine Nursing Outpatients medicine Humans Prospective Studies Adverse effect Propofol Depression (differential diagnoses) Aged Aged 80 and over Hepatology medicine.diagnostic_test Esophagogastroduodenoscopy business.industry Gastroenterology Middle Aged Quality Improvement Endoscopy Patient Satisfaction 030220 oncology & carcinogenesis 030211 gastroenterology & hepatology Female medicine.symptom business Anesthetics Intravenous medicine.drug |
| Zdroj: | Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association. 17(6) |
| ISSN: | 1542-7714 |
| Popis: | Background & Aims Esophagogastroduodenoscopy (EGD) and colonoscopy are common outpatient gastrointestinal endoscopic procedures that frequently use sedation. We aimed to identify a protocol that combines safety with cost effectiveness. Methods We collected data from consecutive outpatients (age, 20–98 y) who underwent diagnostic EGD (n = 117,661) or colonoscopy (n = 32,550) with propofol sedation from January 2006 through December 2016. Propofol was administered by a nurse via bolus injection using an age-adjusted standard protocol, up to a total of 200 mg. The primary outcome measure was occurrence of adverse events within 24 hours. Secondary outcome measures included rates of procedure success, respiratory depression, and other procedure-related adverse events. Results The median dose of propofol administered for EGD was 77 mg (range, 20–160 mg) and for colonoscopy was 99 mg (range, 40–200 mg). Among patients undergoing EGD, those younger than 41 years required 1.5-fold more propofol than patients 61–80 years old. The only adverse event was the transient need for supplemental oxygen supply, required by 1950 patients (1.3%): 1689 undergoing EGD (1.4%) and 261 undergoing colonoscopy (0.8%). Patients were discharged after 60 minutes and at least 66,250 patients (44%) drove themselves from the hospital. None experienced a traffic accident within 24 hours after receiving propofol sedation. Conclusions Nurse-administered propofol monosedation using an age-adjusted standard protocol up to a maximal of 200 mg is safe and practical for outpatient gastrointestinal endoscopy. |
| Databáze: | OpenAIRE |
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