Year 2018 / Volume 110 / Number 4
Original
Sedation with propofol in digestive endoscopy administered by gastroenterologists. Experience in a Venezuelan hospital

246-249

DOI: 10.17235/reed.2018.5185/2017

Ramón E. Ruiz-Curiel, Ydaly Bonilla H., Alberto Baptista, Manuel Bronstein,

Abstract
Objectives: propofol is a rapid acting hypnotic that is becoming the drug of choice for sedation in digestive endoscopy worldwide. There is some controversy with regard to the use of propofol by physicians who are not anesthesiologists. We present our experience of the administration of propofol by endoscopist and nursing personnel. Methods: this was a retrospective study of sedation in endoscopy. Propofol was exclusively used and administered by the endoscopist who performed the procedure and the nursing staff. All patients included were of a low and moderate surgical risk (ASA I, II and III). No complementary medication was used such as benzodiazepines or opiates. Results: a total of 70,696 digestive endoscopy procedures performed between 2002 and 2017 were included in the study. Propofol was administered in an induction bolus of 10 to 50 mg, continuing with intermittent boluses of 10 to 20 mg, according to the patients’ response. The incidence of complications was very low, assisted ventilation with a mask was required on 78 (0.11%) occasions. Only one case required endotracheal intubation and two patients had significant hypotension that required the administration of ephedrine. The average recovery time of all neuropsychomotor functions after the procedure was 15 minutes; 98% of patients reported a good or excellent level of tolerance and clearly remembered the details of the interview one hour after the procedure. Conclusions: the use of propofol as a sedative in digestive endoscopy is a safe and effective technique, provided that it is administered and controlled by the endoscopist and nursing staff in properly selected patients. This allows gastroenterologists to achieve adequate sedation.
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References
BIBLIOGRAFIA
1. COHEN LB, WECSLER JS, GAETANO JN et al. Endoscopic sedation in the United States: Results from a nationwide survey. Am J. Gastroent. 2006;101: 967-974
2. LADAS SD, AABAKKEN L, REY JF et al. Use of sedation for routine diagnostic upper gastrointestinal endoscopy: A european society of gastrointestinal endoscopy survey of national endoscopy society members. Digestion 2006; 74: 69-77
3. VARGO JJ, ZUCCAROG, DUMONT JA. et al. Gastroenterologist administered propofol versus meperidine and midazolan for advanced upper Endoscopy: a prospective, randomized trial. Gastroenterology 2002; 123: 8-16
4. GROSS JB, BAILEY PL, CONNIS RT et al. Practice guidelines for sedation and analgesia by non-anesthesiologist. Anaesthesiology 2002; 96: 1004-1017
5. REX D. Endoscopist Directed Propofol. Gastroint Endoscopy Clin N Am 2016; 26:485-492
6. KNAPE JT, ADRIANSEN H, VAN AKEN H. et al. Guidelines for sedation and/or analgesia by non-anesthesiology doctors. Eur J. Anaesthesiol 2007;24: 563-567
7. VARGO JJ, COHEN LB, REX DK et al Position statement: Non-anesthesiologist administration of propofol for GI Endoscopy. Gastroint Endosc 2009; 70: 1053-1059
7
8. IGEA F, CASELLAS JA, GONZALEZ-HUIX, F et al Sedación en Endoscopia Digestiva. Guia de práctica clínica de la Sociedad Española de Endoscopia Digestiva. Rev. Esp. Enferm Dig. 2014; 106: 195-211
9. Propofol injectable emulsion 1 %, 10 mg/ml. Irvine, Teva Parenteral Medicines, Inc; 2008
10. BAPTISTA A, BONILLA Y, BRONSTEIN M y col. Propofol administrado por Gastroenterólogos para sedación en Endoscopia Digestiva. XXV Congreso Sociedad Venezolana de Gastroenterología. Caracas . GEN 2004; 58 No. 3 172, 2004
11. BAPTISTA A, BONILLA Y, BRONSTEIN M et al. Propofol sedation for gastrointestinal ndoscopy administered by nursing staff under gastroenterologist supervisión. Gastroint. Endosc 2005; 61: 5 AB108
12. RIKER RR, GLISIC EK, FRASER GL Propofol infusión síndrome: difficult to recognize, difficult to study. Crit Care Med 2009; 37: 3169-3170
13. KULLING D, ORLANDI M, INAUEN W. Propofol sedation during endoscopic procedures: How much staff and monitoring are necessary. Gastroint Endosc 2007; 66: 443-449
14. DEENADAYALU VP, EID EF GOFF JS et al. Non-anesthesiologist administered Propofol sedation for endoscopic procedures: a worldwide safety review. San Diego. Digestive Disease Week. 2008. Abstract No. 883
15. REX D, DEENADAYALU VP, EID E. et al. Endoscopist-Directed administration of Propofol: A worldwide safety experience. Gastroenterology 2009; 137: 1229-1237
16. SHAMA VK, NGUYEN CC, CROWELL MD et al. A national study of cardiopulmonary unplanned events after GI Endoscopy. Gastroint Endosc 2007; 66: 27-34
17. BEB DA, JB. Training and Competency in Sedation Practice in Gastrointestinal Endoscopy. Gastroint Endosc Clin N Am 2016; 443-462
18. LUBARSKY DA, CANDIOTTI K, HARRIS E. Understanding modes of moderate sedation during gastrointestinal procedures: A current review of the literatura. J Clin Anesth 2007; 19: 397-404
19. DUMONCEAU JM, RIPHAUS A. ESGE-ESGENA-ESA Guideline for non-anesthesiologist administration of propofol for GI Endoscopy . Endoscopy 2010; 42: 960-974
20. MAHMUD N, BERZIN T, Extended Monitoring during Endoscopy. Gastrointest Endoscopy Clin N Am 2016; 26: 493-505
21. TETZLA J, MAURER W. Preprocedural assessment for sedation in gastrointestinal Endoscopy. Gastroint Endosc Clin N Am. 2016; 26: 433-441
22. COHEN LB, DELEGGE MH, AISENBERG J et al AGA Institute review of endoscopic sedation. Gastroenterology 2007; 133: 675-701
23. REGULA J, SOKOL-KOBIELSA E. Sedation in Endoscopy: When and How. Best Pract & Res Clin Gastroent 2008; 22: 945-957
24. KRALIOS A, FELD, K FELD A. Endoscopic Sedation. Medicolegal Considerations. Gastroint Endoscopy Clin N Am 2016; 26: 463-469
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Ruiz-Curiel R, Bonilla H. Y, Baptista A, Bronstein M. Sedation with propofol in digestive endoscopy administered by gastroenterologists. Experience in a Venezuelan hospital. 5185/2017


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Publication history

Received: 23/07/2017

Accepted: 20/02/2018

Online First: 15/03/2018

Published: 02/04/2018

Article revision time: 208 days

Article Online First time: 235 days

Article editing time: 253 days


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