Document Detail


Conscious sedation for endoscopic and non-endoscopic interventional gastrointestinal procedures: meeting patients' expectations, missing the standard.
MedLine Citation:
PMID:  14746789     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIM: To assess the level of sedation, patient satisfaction and frequency of unplanned events with conscious sedation for interventional procedures. MATERIALS AND METHODS: One hundred and seventeen patients were assessed prospectively before, during and after procedures. Blood pressure, pulse, oxygen saturation and sedation level were monitored and patients followed up after 24 h. Sedation was scored after drugs were given in accordance with an established protocol. Doses were recorded, as were patients' weight, age and ASA grade and any unplanned events and their management. RESULTS: Seventy-six of the 117 patients (65%) had no unplanned event, 20 (17.1%) became agitated, 15 (12.8%) hypotensive, three (2.6%) hypoxic and three (2.6%) had more than one response. Twelve patients required active management. Fifty-two (44.4%) had a sedation level of </=3 (responsive to verbal commands), but 39 (33.3%) reached level 6. Median doses were midazolam 6 mg (1-20 mg) and pethidine 50 mg (12.5-100 mg). Ninety-three percent were satisfied with their sedation. No adverse effects were observed after 24 h. CONCLUSION: Despite using a sedation protocol, unplanned events occurred in 35% (95% CI=27-44%) of patients, although not all required active management. The sedation levels reached in some exceeded guidelines. Unplanned events were commoner with increased sedation level. Patient satisfaction was high and no permanent damage was observed.
Authors:
P Marriott; H-U Laasch; L Wilbraham; A Marriott; R E England; D F Martin
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Clinical radiology     Volume:  59     ISSN:  0009-9260     ISO Abbreviation:  Clin Radiol     Publication Date:  2004 Feb 
Date Detail:
Created Date:  2004-01-28     Completed Date:  2004-03-22     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  1306016     Medline TA:  Clin Radiol     Country:  England    
Other Details:
Languages:  eng     Pagination:  180-5     Citation Subset:  IM    
Affiliation:
Academic Department of GI-Radiology, South Manchester University Hospitals NHS Trust, Manchester, UK.
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MeSH Terms
Descriptor/Qualifier:
Adjuvants, Anesthesia
Aged
Anesthetics, Combined
Anxiety / etiology
Conscious Sedation / adverse effects,  methods*
Endoscopy, Gastrointestinal / methods*
Female
Gastrointestinal Diseases / surgery*
Humans
Intraoperative Complications / etiology
Male
Meperidine / administration & dosage
Midazolam / administration & dosage
Pain, Postoperative / etiology
Patient Satisfaction
Prospective Studies
Chemical
Reg. No./Substance:
0/Adjuvants, Anesthesia; 0/Anesthetics, Combined; 57-42-1/Meperidine; 59467-70-8/Midazolam
Comments/Corrections
Comment In:
Clin Radiol. 2004 Sep;59(9):853-4; author reply 854   [PMID:  15351254 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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