Literature DB >> 23959522

Sedation for interventional gastrointestinal endoscopic procedures: are we overlooking the “pain”?

Seokyung Shin, Sang Kil Lee, Kyung Tae Min, Hyun Ju Kim, Chan Hyuk Park, Young Chul Yoo.   

Abstract

BACKGROUND: Although interventional gastrointestinal (GI) endoscopic procedures are known to cause greater pain and discomfort than diagnostic procedures, the efficacy of adequate pain control or the difference in pain and amount of analgesic required according to type of intervention is not well known. This study was done to investigate the safety and efficacy of combining fentanyl with propofol for interventional GI endoscopic procedures and determine whether this method is superior to propofol monosedation.
METHODS: The data of 810 patients that underwent interventional GI endoscopic procedures under sedation with either propofol alone (Group P, n = 499) or propofol/fentanyl (Group PF, n = 311) at a single tertiary-care hospital between May 2012 and December 2012 were retrospectively reviewed. Rates of respiratory and cardiovascular events, propofol and fentanyl requirements, and risk factors of respiratory events of the two groups were analyzed.
RESULTS: The incidence of respiratory events (P = 0.001), number of cases in which the procedure had to be interrupted for assisted mask bagging (P = 0.044), and propofol infusion rates were significantly lower in Group PF compared to Group P (P < 0.0001). The amount of fentanyl required for diagnostic procedures was significantly lower than that for interventional procedures (P < 0.001). Patients of Group PF showed a lower risk of developing respiratory events compared to Group P (OR 0.224, 95 % CI 0.069–0.724).
CONCLUSIONS: Combining fentanyl with propofol seems to reduce the risk of respiratory events compared with propofol monosedation during GI endoscopic procedures by providing effective analgesia.

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Year:  2014        PMID: 23959522     DOI: 10.1007/s00464-013-3133-y

Source DB:  PubMed          Journal:  Surg Endosc        ISSN: 0930-2794            Impact factor:   4.584


  22 in total

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2.  The burden of endoscopic retrograde cholangiopancreatography (ERCP) performed with the patient under conscious sedation.

Authors:  S M Jeurnink; E W Steyerberg; E J Kuipers; P D Siersema
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3.  The changing landscape of practice patterns regarding unsedated endoscopy and propofol use: a national Web survey.

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4.  Sedation with propofol plus midazolam versus propofol alone for interventional endoscopic procedures: a prospective, randomized study.

Authors:  H Seifert; T H Schmitt; T Gültekin; W F Caspary; T Wehrmann
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5.  Propofol alone titrated to deep sedation versus propofol in combination with opioids and/or benzodiazepines and titrated to moderate sedation for colonoscopy.

Authors:  Megan E VanNatta; Douglas K Rex
Journal:  Am J Gastroenterol       Date:  2006-10       Impact factor: 10.864

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Authors:  Davinder Garewal; Steve Powell; Stephen J Milan; Jonas Nordmeyer; Pallavi Waikar
Journal:  Cochrane Database Syst Rev       Date:  2012-06-13

8.  Incidence of sedation-related complications with propofol use during advanced endoscopic procedures.

Authors:  Gregory A Coté; Robert M Hovis; Michael A Ansstas; Lawrence Waldbaum; Riad R Azar; Dayna S Early; Steven A Edmundowicz; Daniel K Mullady; Sreenivasa S Jonnalagadda
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9.  Sedation with propofol for interventional endoscopic procedures: a risk factor analysis.

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Journal:  Scand J Gastroenterol       Date:  2008-03       Impact factor: 2.423

10.  Propofol sedation for ERCP procedures: a dilemna? Observations from an anesthesia perspective.

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Journal:  Diagn Ther Endosc       Date:  2012-01-05
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3.  Outcomes of Propofol Sedation During Emergency Endoscopy Performed for Upper Gastrointestinal Bleeding.

Authors:  Chan Hyuk Park; Dong Soo Han; Jae Yoon Jeong; Chang Soo Eun; Kyo-Sang Yoo; Yong Cheol Jeon; Joo Hyun Sohn
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4.  Assessing the stability and safety of procedure during endoscopic submucosal dissection according to sedation methods: a randomized trial.

Authors:  Chan Hyuk Park; Seokyung Shin; Sang Kil Lee; Hyuk Lee; Yong Chan Lee; Jun Chul Park; Young Chul Yoo
Journal:  PLoS One       Date:  2015-03-24       Impact factor: 3.240

Review 5.  Endoscopic sedation: risk assessment and monitoring.

Authors:  Young Chul Yoo
Journal:  Clin Endosc       Date:  2014-03-31

6.  Pro: propofol in endoscopy.

Authors:  Alexandre Oliveira Ferreira; Marília Cravo
Journal:  Clin Endosc       Date:  2014-11-30

7.  Safety and efficacy of combined use of propofol and etomidate for sedation during gastroscopy: Systematic review and meta-analysis.

Authors:  Lingyuan Chen; Xueyan Liang; Xinmei Tan; Haibin Wen; Junsong Jiang; Yan Li
Journal:  Medicine (Baltimore)       Date:  2019-05       Impact factor: 1.817

8.  Conventional versus Analgesia-Oriented Combination Sedation on Recovery Profiles and Satisfaction after ERCP: A Randomized Trial.

Authors:  Seokyung Shin; Tak Geun Oh; Moon Jae Chung; Jeong Youp Park; Seung Woo Park; Jae Bok Chung; Si Young Song; Jooyoun Cho; Sang-Hun Park; Young Chul Yoo; Seungmin Bang
Journal:  PLoS One       Date:  2015-09-24       Impact factor: 3.240

9.  Efficacy of Intravenous Lidocaine During Endoscopic Submucosal Dissection for Gastric Neoplasm: A Randomized, Double-Blind, Controlled Study.

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  9 in total

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