Advances in Analgosedation and Periprocedural Care for Gastrointestinal Endoscopy

Škiljić, Sonja; Budrovac, Dino; Cicvarić, Ana; Nešković, Nenad; Kvolik, Slavica

doi:10.3390/life13020473

Cited by 9 publications

(5 citation statements)

References 68 publications

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“…The substantial decreases in the duration required for initial diagnosis, completion of procedures, and recuperation not only enhance the quality of life for patients but also possess the capacity to optimize the allocation of healthcare resources. These enhancements hold significant importance, especially in high‐volume clinical environments where even slight increases in efficiency can result in considerable cumulative effects 18,19 …”

Section: Discussionmentioning

confidence: 99%

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Assessing wound complications in gastroscopy with Streptomyces protease enzyme combined with Shutai

Chen,

Li,

Zhou

et al. 2024

International Wound Journal

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Current gastroscopy practices necessitate a balance between procedural efficiency and patient safety. It has been hypothesized that increasing procedure outcomes through the use of Streptomyces protease enzyme and Shutai is possible; however, precise nature of any potential adverse reactions and complications remains unknown. In Zhanjiang, China, 213 patients undergoing gastroscopy participated in this controlled trial. The subjects were allocated at random into two groups: control and treatment. The treatment group was administered topical Streptomyces protease enzyme and intravenous Shutai. Using chi‐square and t‐tests, information regarding patient demographics, adverse reactions, wound healing, procedure duration, distress levels, and satisfaction was gathered and analysed. The demographic and medical history characteristics of the groups were comparable. There was a greater prevalence of modest immediate reactions in the treatment group (p < 0.05), whereas there were no significant variations observed in delayed reactions and long‐term complications (p > 0.05). The treatment group exhibited superior efficiency metrics, including shorter durations for diagnosis, procedure completion and recuperation (p < 0.05). The treatment group exhibited significantly higher patient satisfaction scores (p < 0.05). The incorporation of Streptomyces protease enzyme and Shutai into gastroscopy procedures resulted in significantly enhanced level of procedural efficacy and patient contentment while not introducing an additional risk of long‐term complications. The increase in moderate immediate reactions that have been observed requires additional research in order to determine their clinical significance. Although these agents present a possible progression in the field of gastroscopy, their application should be tempered by the immediate adverse reactions that have been documented.

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Section: Discussionmentioning

confidence: 99%

“…These enhancements hold significant importance, especially in high-volume clinical environments where even slight increases in efficiency can result in considerable cumulative effects. 18,19 4.4 | Patient's satisfaction…”

Section: Procedures Efficacymentioning

confidence: 99%

Assessing wound complications in gastroscopy with Streptomyces protease enzyme combined with Shutai

Chen,

Li,

Zhou

et al. 2024

International Wound Journal

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“…Anesthetic drugs may be associated with postprocedural immunosuppression, either directly by activating immune mediating cells or indirectly by modulating the stress response. Studies have investigated which anesthetics may alter the functions of immunocompetent cells and change the expression of inflammatory mediator genes [ 8 , 9 , 10 , 11 ].…”

Section: Introductionmentioning

confidence: 99%

Anesthesia Medication’s Impacts on Inflammatory and Neuroendocrine Immune Response in Patients Undergoing Digestive Endoscopy

Popa-Ion,

Boldeanu,

Gheonea

et al. 2024

Clinics and Practice

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The aim of this study was to explore the impact of anesthetic drugs currently used to perform lower digestive endoscopy on serum concentrations of inflammation markers and catecholamines. We selected 120 patients and divided them into three lots of 40 patients each: L1, in which no anesthetics were used; L2, in which propofol was used; and L3, in which propofol combined with fentanyl was used. All patients had serum concentrations of adrenaline/epinephrine (EPI), noradrenaline/norepinephrine (NE), tumor necrosis factor alpha (TNF-α), interleukin-4 (IL-4), IL-6, IL-8, and IL-10, taken at three time points: at the beginning of the endoscopic procedure (T0), 15 min after (T1), and 2 h after the end of the endoscopic procedure (T2). The results of the research showed changes in the levels of catecholamines and interleukins (ILs) at T0, with an increased response in L1 above the mean recorded in L2 and L3 (p < 0.001). At T1, increased values were recorded in all lots; values were significantly higher in L1. At T2, the values recorded in L3 were significantly lower than the values in L2 (student T, p < 0.001) and L1, in which the level of these markers continued to increase, reaching double values compared to T0 (student T, p < 0.001). In L2 at T1, the dose of propofol correlated much better with NE, EPI, and well-known cytokines. Our results show that propofol combined with fentanyl can significantly inhibit the activation of systemic immune and neuroendocrine response during painless lower digestive endoscopy.

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“…Worldwide, gastrointestinal (GI) endoscopy is routinely performed for diagnostic and therapeutic interventions for various GI pathologies, both in an inpatient and outpatient setting[ 1 , 2 ]. However, if performed without sedation, endoscopy can be uncomfortable for patients due to intra-procedure complications such as gagging, coughing and choking during upper GI examination, and abdominal pain, abdominal discomfort and bloating during lower GI examination[ 3 ].…”

Section: Introductionmentioning

confidence: 99%

Remimazolam for sedation in gastrointestinal endoscopy: A comprehensive review

Dahiya,

Kumar,

Parsa

et al. 2024

World J Gastrointest Endosc

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Worldwide, a majority of routine endoscopic procedures are performed under some form of sedation to maximize patient comfort. Propofol, benzodiazepines and opioids continue to be widely used. However, in recent years, Remimazolam is gaining immense popularity for procedural sedation in gastrointestinal (GI) endoscopy. It is an ultra-short-acting benzodiazepine sedative which was approved by the Food and Drug Administration in July 2020 for use in procedural sedation. Remimazolam has shown a favorable pharmacokinetic and pharmacodynamic profile in terms of its non-specific metabolism by tissue esterase, volume of distribution, total body clearance, and negligible drug-drug interactions. It also has satisfactory efficacy and has achieved high rates of successful sedation in GI endoscopy. Furthermore, studies have demonstrated that the efficacy of Remimazolam is non-inferior to Propofol, which is currently a gold standard for procedural sedation in most parts of the world. However, the use of Propofol is associated with hemodynamic instability and respiratory depression. In contrast, Remimazolam has lower incidence of these adverse effects intra-procedurally and hence, may provide a safer alternative to Propofol in procedural sedation. In this comprehensive narrative review, highlight the pharmacologic characteristics, efficacy, and safety of Remimazolam for procedural sedation. We also discuss the potential of Remimazolam as a suitable alternative and how it can shape the future of procedural sedation in gastroenterology.

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Advances in Analgosedation and Periprocedural Care for Gastrointestinal Endoscopy

Cited by 9 publications

References 68 publications

Assessing wound complications in gastroscopy with Streptomyces protease enzyme combined with Shutai

Assessing wound complications in gastroscopy with Streptomyces protease enzyme combined with Shutai

Anesthesia Medication’s Impacts on Inflammatory and Neuroendocrine Immune Response in Patients Undergoing Digestive Endoscopy

Remimazolam for sedation in gastrointestinal endoscopy: A comprehensive review

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