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Efficacy and safety of nurse-administered propofol sedation during emergency upper endoscopy for gastrointestinal bleeding: a prospective study.
Endoscopy. 2006 Jul; 38(7):684-9.E

Abstract

BACKGROUND AND STUDY AIMS

Recent studies have documented the safety of propofol sedation for endoscopic procedures, but many endoscopists are reluctant to use propofol for high-risk patients because of adverse effects. The aim of this study was to demonstrate the safety and efficacy of nurse-administered propofol sedation during emergency upper endoscopy for patients with gastrointestinal bleeding.

PATIENTS AND METHODS

Over a period of 18 months, 120 patients suffering from acute upper gastrointestinal bleeding received propofol sedation administered by a registered nurse. Among these, 15 patients were classified into American Society of Anesthesiologists (ASA) class IV, 84 were ASA class III, and 21 were ASA class II. Patients without gastrointestinal bleeding, who also received propofol during the same period and were matched for age, gender, and ASA class, served as controls.

RESULTS

Endoscopic hemostasis was achieved in 98.3 % of patients, and 97.5 % were satisfied with the procedure. In patients with gastrointestinal bleeding, the rates of hypotension (systolic blood pressure < 90 mmHg) and hypoxemia (peripheral oxygen saturation < 90 %) were 8.3 % and 6.7 % respectively, values higher than those in the control group. However, neither mask ventilation nor endotracheal intubation was necessary. Although two patients with gastrointestinal bleeding developed pneumonia, most likely due to aspiration during the procedure, they recovered within 5 days of treatment. There were no sedation-associated severe complications or mortalities.

CONCLUSION

Using a strict protocol designed to protect the patient's airway and cardiovascular function, nurse-administered propofol sedation during emergency upper gastrointestinal endoscopy is safe and appropriate in cases of acute gastrointestinal bleeding.

Authors+Show Affiliations

Department of Gastroenterology, Yujin Yamazaki Hospital, Hikone, Shiga, Japan. genkipapa178@yahoo.co.jpNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

16761209

Citation

Tohda, G, et al. "Efficacy and Safety of Nurse-administered Propofol Sedation During Emergency Upper Endoscopy for Gastrointestinal Bleeding: a Prospective Study." Endoscopy, vol. 38, no. 7, 2006, pp. 684-9.
Tohda G, Higashi S, Sakumoto H, et al. Efficacy and safety of nurse-administered propofol sedation during emergency upper endoscopy for gastrointestinal bleeding: a prospective study. Endoscopy. 2006;38(7):684-9.
Tohda, G., Higashi, S., Sakumoto, H., Sumiyoshi, K., & Kane, T. (2006). Efficacy and safety of nurse-administered propofol sedation during emergency upper endoscopy for gastrointestinal bleeding: a prospective study. Endoscopy, 38(7), 684-9.
Tohda G, et al. Efficacy and Safety of Nurse-administered Propofol Sedation During Emergency Upper Endoscopy for Gastrointestinal Bleeding: a Prospective Study. Endoscopy. 2006;38(7):684-9. PubMed PMID: 16761209.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Efficacy and safety of nurse-administered propofol sedation during emergency upper endoscopy for gastrointestinal bleeding: a prospective study. AU - Tohda,G, AU - Higashi,S, AU - Sakumoto,H, AU - Sumiyoshi,K, AU - Kane,T, Y1 - 2006/06/06/ PY - 2006/6/9/pubmed PY - 2006/12/21/medline PY - 2006/6/9/entrez SP - 684 EP - 9 JF - Endoscopy JO - Endoscopy VL - 38 IS - 7 N2 - BACKGROUND AND STUDY AIMS: Recent studies have documented the safety of propofol sedation for endoscopic procedures, but many endoscopists are reluctant to use propofol for high-risk patients because of adverse effects. The aim of this study was to demonstrate the safety and efficacy of nurse-administered propofol sedation during emergency upper endoscopy for patients with gastrointestinal bleeding. PATIENTS AND METHODS: Over a period of 18 months, 120 patients suffering from acute upper gastrointestinal bleeding received propofol sedation administered by a registered nurse. Among these, 15 patients were classified into American Society of Anesthesiologists (ASA) class IV, 84 were ASA class III, and 21 were ASA class II. Patients without gastrointestinal bleeding, who also received propofol during the same period and were matched for age, gender, and ASA class, served as controls. RESULTS: Endoscopic hemostasis was achieved in 98.3 % of patients, and 97.5 % were satisfied with the procedure. In patients with gastrointestinal bleeding, the rates of hypotension (systolic blood pressure < 90 mmHg) and hypoxemia (peripheral oxygen saturation < 90 %) were 8.3 % and 6.7 % respectively, values higher than those in the control group. However, neither mask ventilation nor endotracheal intubation was necessary. Although two patients with gastrointestinal bleeding developed pneumonia, most likely due to aspiration during the procedure, they recovered within 5 days of treatment. There were no sedation-associated severe complications or mortalities. CONCLUSION: Using a strict protocol designed to protect the patient's airway and cardiovascular function, nurse-administered propofol sedation during emergency upper gastrointestinal endoscopy is safe and appropriate in cases of acute gastrointestinal bleeding. SN - 0013-726X UR - https://www.unboundmedicine.com/medline/citation/16761209/Efficacy_and_safety_of_nurse_administered_propofol_sedation_during_emergency_upper_endoscopy_for_gastrointestinal_bleeding:_a_prospective_study_ DB - PRIME DP - Unbound Medicine ER -