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Propofol infusion versus intermittent meperidine and midazolam injection for conscious sedation in ERCP.
J Gastrointestin Liver Dis. 2008 Sep; 17(3):291-7.JG

Abstract

BACKGROUND AND AIM

ERCP generally requires longer time than standard endoscopy. Only few studies have shown benefit of intermittent propofol over conventional sedation. This study was conducted to compare satisfaction, recovery score, and recovery/safety profiles for ERCP sedation between continuous infusion of propofol and conventional sedation.

PATIENTS AND METHODS

One hundred thirty-four patients with ASA I-III underwent ERCP and were randomly assigned into two groups (n=67 each). Patients underwent propofol sedation or meperidine/midazolam sedation. Supplemental oxygen was offered only when oxygen saturation was lower than 90 %. Oxygen saturation, blood pressure, heart rate, recovery score, times for recovery and satisfaction score after procedure were recorded and analyzed.

RESULTS

Average amount of meperidine, midazolam and propofol per each patient were 61.54 (+/- 27.29), 7.80 (+/- 3.73), 299.90 (+/- 146.15) mg, respectively. Time to regain full consciousness in the propofol arm was significantly shorter than in the conventional arm (17.24 +/- 5.99 versus 34.25 +/- 16.06 min, p<0.001). The rates of desaturation, bradycardia and hypotension in both arms were low and comparable. Propofol provided higher level of recovery scores at 15, 30, 45 and 60 min after the procedure (p < 0.001).

CONCLUSION

Continuous infusion of propofol for ERCP by direction of gastroenterologist yields no difference in the completion rate and adverse profiles when compared with conventional technique but it provides a better recovery profile. The maintainance of appropriate level of sedation by well trained personnel is the key to achieve this success.

Authors+Show Affiliations

Division of Gastroenterology, Department of Internal Medicine, Chulalongkorn University, Bangkok, Thailand.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

18836622

Citation

Kongkam, Pradermchai, et al. "Propofol Infusion Versus Intermittent Meperidine and Midazolam Injection for Conscious Sedation in ERCP." Journal of Gastrointestinal and Liver Diseases : JGLD, vol. 17, no. 3, 2008, pp. 291-7.
Kongkam P, Rerknimitr R, Punyathavorn S, et al. Propofol infusion versus intermittent meperidine and midazolam injection for conscious sedation in ERCP. J Gastrointestin Liver Dis. 2008;17(3):291-7.
Kongkam, P., Rerknimitr, R., Punyathavorn, S., Sitthi-Amorn, C., Ponauthai, Y., Prempracha, N., & Kullavanijaya, P. (2008). Propofol infusion versus intermittent meperidine and midazolam injection for conscious sedation in ERCP. Journal of Gastrointestinal and Liver Diseases : JGLD, 17(3), 291-7.
Kongkam P, et al. Propofol Infusion Versus Intermittent Meperidine and Midazolam Injection for Conscious Sedation in ERCP. J Gastrointestin Liver Dis. 2008;17(3):291-7. PubMed PMID: 18836622.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Propofol infusion versus intermittent meperidine and midazolam injection for conscious sedation in ERCP. AU - Kongkam,Pradermchai, AU - Rerknimitr,Rungsun, AU - Punyathavorn,Sahadol, AU - Sitthi-Amorn,Chitr, AU - Ponauthai,Yuwadee, AU - Prempracha,Narongrit, AU - Kullavanijaya,Pinit, PY - 2008/10/7/pubmed PY - 2008/12/31/medline PY - 2008/10/7/entrez SP - 291 EP - 7 JF - Journal of gastrointestinal and liver diseases : JGLD JO - J Gastrointestin Liver Dis VL - 17 IS - 3 N2 - BACKGROUND AND AIM: ERCP generally requires longer time than standard endoscopy. Only few studies have shown benefit of intermittent propofol over conventional sedation. This study was conducted to compare satisfaction, recovery score, and recovery/safety profiles for ERCP sedation between continuous infusion of propofol and conventional sedation. PATIENTS AND METHODS: One hundred thirty-four patients with ASA I-III underwent ERCP and were randomly assigned into two groups (n=67 each). Patients underwent propofol sedation or meperidine/midazolam sedation. Supplemental oxygen was offered only when oxygen saturation was lower than 90 %. Oxygen saturation, blood pressure, heart rate, recovery score, times for recovery and satisfaction score after procedure were recorded and analyzed. RESULTS: Average amount of meperidine, midazolam and propofol per each patient were 61.54 (+/- 27.29), 7.80 (+/- 3.73), 299.90 (+/- 146.15) mg, respectively. Time to regain full consciousness in the propofol arm was significantly shorter than in the conventional arm (17.24 +/- 5.99 versus 34.25 +/- 16.06 min, p<0.001). The rates of desaturation, bradycardia and hypotension in both arms were low and comparable. Propofol provided higher level of recovery scores at 15, 30, 45 and 60 min after the procedure (p < 0.001). CONCLUSION: Continuous infusion of propofol for ERCP by direction of gastroenterologist yields no difference in the completion rate and adverse profiles when compared with conventional technique but it provides a better recovery profile. The maintainance of appropriate level of sedation by well trained personnel is the key to achieve this success. SN - 1841-8724 UR - https://www.unboundmedicine.com/medline/citation/18836622/Propofol_infusion_versus_intermittent_meperidine_and_midazolam_injection_for_conscious_sedation_in_ERCP_ L2 - https://www.jgld.ro/jgld/index.php/jgld/article/view/2008.3.7 DB - PRIME DP - Unbound Medicine ER -