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01.08.2012 | Original Article

Balanced Propofol Sedation Versus Propofol Monosedation in Therapeutic Pancreaticobiliary Endoscopic Procedures

verfasst von: Tae Hoon Lee, Chang Kyun Lee, Sang-Heum Park, Suck-Ho Lee, Il-Kwun Chung, Hyun Jong Choi, Sang Woo Cha, Jong Ho Moon, Young Deok Cho, Young Hwangbo, Sun-Joo Kim

Erschienen in: Digestive Diseases and Sciences | Ausgabe 8/2012

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Abstract

Background

Prolonged or complex endoscopic procedures are frequently performed under deep sedation. However, no studies of therapeutic ERCP have yet compared the use of balanced propofol sedation (BPS) to propofol alone, titrated to moderate levels of sedation.

Aim

This prospective, randomized, double-blind study was planned to compare the sedation efficacy and safety of BPS (propofol in combination with midazolam and fentanyl) and propofol monosedation in therapeutic ERCP and EUS.

Methods

BPS, or propofol monosedation titrated to a moderate level of sedation, was performed by trained registered nurses under endoscopist supervision. The main outcome measurements included sedation efficacy focusing on recovery time, sedation safety, endoscopic procedure outcomes, and complications.

Results

There were no significant differences in sedation efficacy, safety, procedure outcomes, and complications, with the exception of recovery time. Mean recovery time (standard deviation) was 18.37 (7.86) min in BPS and 13.4 (6.24) min in propofol monosedation (P < 0.001). In a safety analysis, cardiopulmonary complication rates related to BPS and propofol monosedation were 7.8 % (8/102) and 9.6 % (10/104), respectively (P = 0.652). No patient required assisted ventilation or permanent termination of a procedure in either group. Technical success of the endoscopic procedures was 96.3 and 97.2 %, respectively (P = 0.701). Endoscopic procedure-related complications and outcomes did not differ depending on sedation procedure.

Conclusions

Propofol monosedation by trained, registered sedation nurses under supervision resulted in a more rapid recovery time than BPS. There were no differences in the sedation safety, endoscopic procedure outcomes, and complications between BPS and propofol monosedation.

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Titel: Balanced Propofol Sedation Versus Propofol Monosedation in Therapeutic Pancreaticobiliary Endoscopic Procedures
verfasst von: Tae Hoon Lee
Chang Kyun Lee
Sang-Heum Park
Suck-Ho Lee
Il-Kwun Chung
Hyun Jong Choi
Sang Woo Cha
Jong Ho Moon
Young Deok Cho
Young Hwangbo
Sun-Joo Kim
Publikationsdatum: 01.08.2012
Verlag: Springer US
Erschienen in: Digestive Diseases and Sciences / Ausgabe 8/2012
Print ISSN: 0163-2116
Elektronische ISSN: 1573-2568
DOI: https://doi.org/10.1007/s10620-012-2234-0

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