Year 2018 / Volume 110 / Number 4
Original
The safety of deep sedation with propofol controlled by the endoscopist in endoscopic retrograde cholangiopancreatography (ERCP): a prospective study in a tertiary hospital

217-222

DOI: 10.17235/reed.2018.5262/2017

Lara Luzón Solanas, Leticia Ollero Domenche, Eva María Sierra Moros, José Val Pérez, María Teresa Soria San Teodoro, Teresa Giménez Júlvez, Rafael Uribarrena Amezaga,

Abstract
Introduction: propofol administered by an endoscopist with a trained nurse has evolved as an alternative to anesthesia monitoring and is increasingly common in the routine clinical practice, even in advanced endoscopy. Objective: to evaluate the safety of deep sedation with endoscopist-controlled propofol in patients undergoing endoscopic retrograde cholangiopancreatography (ERCP). Material and methods: this was a prospective study in patients undergoing ERCP under deep sedation with propofol. Different patient-related variables were included and the initial and final data on oxygen saturation (SatO2), blood pressure (BP) and heart rate (HR) were recorded in order to determine the presence of adverse events due to sedation (hypoxemia, hypotension, or bradycardia). Results: a total of 661 patients underwent ERCP under sedation with propofol over a 24-month period. The rate of recorded adverse events was 9.7%. The most frequent adverse event was hypoxemia (5.7%), followed by bradycardia (2.4%) and hypotension (1.6%). According to the univariate analysis, the occurrence of adverse events due to sedation (AES) was associated with an ASA score ≥ III (p = 0.026), older patients (p = 0.009), higher body mass index (BMI) (p = 0.002) and a longer exploration time (p = 0.034). The induction dose of propofol was also associated with a greater likelihood of adverse events (p = 0.045) but not the total dose of propofol administered (p = 0.153). According to the multivariate logistic regression analysis, age, body mass index (BMI) and the duration of the exploration were independent predictors of SAE (p < 0.05). Conclusion: deep sedation with propofol controlled by trained endoscopy staff is a safe method in complex endoscopic procedures such as ERCP.
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Citation tools
Luzón Solanas L, Ollero Domenche L, Sierra Moros E, Val Pérez J, Soria San Teodoro M, Giménez Júlvez T, et all. The safety of deep sedation with propofol controlled by the endoscopist in endoscopic retrograde cholangiopancreatography (ERCP): a prospective study in a tertiary hospital. 5262/2017


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Publication history

Received: 15/09/2017

Accepted: 02/01/2018

Online First: 09/02/2018

Published: 02/04/2018

Article revision time: 103 days

Article Online First time: 147 days

Article editing time: 199 days


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