Seung In Seo1, Ji Yon Ryu1, Sang Soo Kang2, Jin Seo Lee3, Hyoung Su Kim1, Myoung Kuk Jang1, Hak Yang Kim1, Woon Geon Shin4,5,6. 1. Department of Internal Medicine, Hallym University College of Medicine, Seoul, Korea. 2. Department of Anesthesiology, Hallym University College of Medicine, Seoul, Korea. 3. Department of Clinical Immunology, Hallym University College of Medicine, Seoul, Korea. 4. Department of Internal Medicine, Hallym University College of Medicine, Seoul, Korea. sgun9139@gmail.com. 5. Department of Clinical Immunology, Hallym University College of Medicine, Seoul, Korea. sgun9139@gmail.com. 6. Division of Gastroenterology, Department of Internal Medicine, Kangdong Sacred Heart Hospital, 445, Gil-dong, Kangdong-gu, Seoul, 134-701, Korea. sgun9139@gmail.com.
Abstract
BACKGROUND: A target-controlled infusion (TCI) of a propofol system uses a pharmacokinetic model to achieve and maintain a selected target blood propofol concentration. The aim of this study was to assess whether the propofol TCI system could be safely used by gastroenterologists in patients undergoing endoscopic resection including endoscopic submucosal dissection (ESD) and endoscopic mucosal resection (EMR) compared with a manually controlled infusion (MCI) system. METHODS: A total of 431 patients undergoing therapeutic endoscopy (178 ESD and 253 EMR) were consecutively included from November 2011 to August 2014. The patients were divided into the MCI (271) and TCI (160) propofol infusion groups. We compared adverse event rates in MCI and TCI groups and assessed independent risk factors for adverse events. RESULTS: The total sedation-related adverse event rate was 5.8 % (25/431). Most of the events were minor, and the rate of major events was 0.5 % (2/431). There was no significant difference in adverse event rate between the MCI and TCI groups [5.5 % (15/271) vs. 6.3 % (10/160); P = 0.759]. In univariate analysis, the propofol infusion time was significantly associated with adverse events (94.88 vs. 59.45 min, P = 0.017). In the multivariate analysis, there were no significant factors associated with adverse events. TCI was not an independent risk factor for adverse events despite the fact that the TCI had a longer duration of infusion and higher total infusion dose (95 % CI, 0.343-2.216; P = 0.773). CONCLUSIONS: TCI of propofol by gastroenterologists may provide safe sedation in patients undergoing ESD and EMR under careful respiratory monitoring.
BACKGROUND: A target-controlled infusion (TCI) of a propofol system uses a pharmacokinetic model to achieve and maintain a selected target blood propofol concentration. The aim of this study was to assess whether the propofolTCI system could be safely used by gastroenterologists in patients undergoing endoscopic resection including endoscopic submucosal dissection (ESD) and endoscopic mucosal resection (EMR) compared with a manually controlled infusion (MCI) system. METHODS: A total of 431 patients undergoing therapeutic endoscopy (178 ESD and 253 EMR) were consecutively included from November 2011 to August 2014. The patients were divided into the MCI (271) and TCI (160) propofol infusion groups. We compared adverse event rates in MCI and TCI groups and assessed independent risk factors for adverse events. RESULTS: The total sedation-related adverse event rate was 5.8 % (25/431). Most of the events were minor, and the rate of major events was 0.5 % (2/431). There was no significant difference in adverse event rate between the MCI and TCI groups [5.5 % (15/271) vs. 6.3 % (10/160); P = 0.759]. In univariate analysis, the propofol infusion time was significantly associated with adverse events (94.88 vs. 59.45 min, P = 0.017). In the multivariate analysis, there were no significant factors associated with adverse events. TCI was not an independent risk factor for adverse events despite the fact that the TCI had a longer duration of infusion and higher total infusion dose (95 % CI, 0.343-2.216; P = 0.773). CONCLUSIONS:TCI of propofol by gastroenterologists may provide safe sedation in patients undergoing ESD and EMR under careful respiratory monitoring.
Authors: L Fanti; M Agostoni; P G Arcidiacono; A Albertin; G Strini; S Carrara; M Guslandi; G Torri; P A Testoni Journal: Dig Liver Dis Date: 2006-10-16 Impact factor: 4.088
Authors: Douglas K Rex; Viju P Deenadayalu; Emely Eid; Thomas F Imperiale; John A Walker; Kuldip Sandhu; Anthony C Clarke; Lybus C Hillman; Akira Horiuchi; Lawrence B Cohen; Ludwig T Heuss; Shajan Peter; Christoph Beglinger; James A Sinnott; Thomas Welton; Magdy Rofail; Iyad Subei; Rodger Sleven; Paul Jordan; John Goff; Patrick D Gerstenberger; Harold Munnings; Martin Tagle; Brian W Sipe; Till Wehrmann; Jack A Di Palma; Kaitlin E Occhipinti; Egidio Barbi; Andrea Riphaus; Stephen T Amann; Gen Tohda; Timothy McClellan; Charles Thueson; John Morse; Nizam Meah Journal: Gastroenterology Date: 2009-06-21 Impact factor: 22.682