Document Detail


Is propofol sedation with midazolam induction safe during endoscopic procedures without anesthesiologist?
MedLine Citation:
PMID:  21033209     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND/AIMS: Sedation is important for the success and quality of endoscopy. We aimed to evaluate the safety of propofol during the endoscopy under supervision of a gastroenterologist without an anesthesiologist.
METHODOLOGY: All propofol using endoscopic procedures between January 2004 and December 2008 were evaluated retrospectively. All patients received i.v. propofol plus midazolam during the procedures. Blood pressure, heart rate and pO2 saturation were all recorded before and during the procedures.
RESULTS: Mean age of patients was 39.13 +/- 12.9 years (45% male). 50 endoscopic retrograde colangiography, 1430 colonoscopy, 2478 gastroscopy and 210 double balloon enteroscopy procedures were evaluated. First i.v. midazolam (mean 3 +/- 1.1 mg) was used for sedation, then i.v. propofol (mean dose 50 +/- 10 mg) was titrated to achieve deep sedation. Before the procedures, mean pO2, systolic blood pressure, and heart rate were 95 +/- 3%, 120 +/- 25 mmHg, 87 +/- 20, respectively. Mean pO2 decreased significantly during the procedures (from 95 +/- 3% to 83 +/- 5%) (p < 0.005). Only one patient needed tracheal intubation. Arterial hypotension (< 90 mmHg systolic pressure) was observed in 10% of patients (p > 0.05). Two percent of patients had bradycardia (Heart rate < 50 min).
CONCLUSION: Using propofol after midazolam induction seems to be feasible only if the patients are carefully observed and their vital functions monitored during the procedures.
Authors:
Umit Akyuz; Cengiz Pata; Volkan Senkal; Yusuf Erzin
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Hepato-gastroenterology     Volume:  57     ISSN:  0172-6390     ISO Abbreviation:  Hepatogastroenterology     Publication Date:    2010 Jul-Aug
Date Detail:
Created Date:  2010-10-29     Completed Date:  2011-01-06     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8007849     Medline TA:  Hepatogastroenterology     Country:  Greece    
Other Details:
Languages:  eng     Pagination:  685-7     Citation Subset:  IM    
Affiliation:
Yeditepe University Medical Faculty, Department of Gastroenterology, Kozyatagi, Istanbul, Turkey. akyuzfu@yahoo.com
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MeSH Terms
Descriptor/Qualifier:
Adult
Cholangiopancreatography, Endoscopic Retrograde
Colonoscopy
Conscious Sedation*
Endoscopy, Digestive System* / methods
Feasibility Studies
Female
Gastroscopy
Humans
Hypnotics and Sedatives
Male
Midazolam
Monitoring, Intraoperative
Propofol
Retrospective Studies
Chemical
Reg. No./Substance:
0/Hypnotics and Sedatives; 2078-54-8/Propofol; 59467-70-8/Midazolam

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


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