Safety and efficacy of endoscopist-directed balanced propofol sedation during endoscopic retrograde cholangiopancreatography
| Autor: | Alon Lapidus, Alain Suissa, Iyad Khamaysi, Ian M. Gralnek, K. Yassin |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
moderate sedation
endoscopic retrograde cholangiopancreatography Sedation medicine.medical_treatment 03 medical and health sciences 0302 clinical medicine 030202 anesthesiology medicine Intubation endoscopy balanced propofol sedation Propofol Endoscopic retrograde cholangiopancreatography medicine.diagnostic_test business.industry Gastroenterology 030208 emergency & critical care medicine Retrospective cohort study digestive system diseases anesthesiology surgical procedures operative Anesthesia Ambulatory Cohort Original Article medicine.symptom business Mallampati score medicine.drug |
| Zdroj: | Annals of Gastroenterology |
| ISSN: | 1792-7463 1108-7471 |
| Popis: | Background Endoscopist-directed balanced propofol sedation (BPS) appears to be safe and effective for routine endoscopy. However, there are limited data on its use in endoscopic retrograde cholangiopancreatography (ERCP). We evaluated the safety and efficacy of endoscopist-directed BPS for ERCP, and compared patient outcomes with anesthesiologist-administered moderate sedation. Methods This was a retrospective cohort study, using prospectively collected endoscopy data from a tertiary care medical center where endoscopist-directed BPS during ERCP is routine practice. Adverse outcomes included need for bag-mask ventilation or intubation, aborted ERCP due to sedation, hospital admission post-ERCP (outpatients)/change in the level of care (inpatients), and death within 24 h. Results A total of 501 patients underwent ERCP with the use of endoscopist-directed BPS: Cohort 1 - 380 (76%) inpatients, mean age 64.1, 46% male, 24% American Society of Anesthesiologists physical status (ASA) score I, 65% ASA II, 11% ASA III. Concurrently, 24 patients received anesthesiologist-administered moderate sedation: Cohort 2 - 19 (79%) inpatients, mean age 65.0, 67% male, 12% ASA I, 25% ASA II, 38% ASA III, 25% ASA IV. In Cohort 1, none of the adverse outcomes were observed. Propofol dose was inversely correlated with age (r=-0.42, P |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|