Can Sedation Reduce the Cardiac Stress During Gastrointestinal Endoscopy? A Study With Non-invasive Automated Cardiac Flow Measurement by Color Doppler Echocardiography

Yazawa, Kazuyuki; Adachi, Wataru; Owa, Mafumi; Koide, Naoki; Hanazaki, Kazuhiro; Kajikawa, Shoji; Kobayashi, Shinya; Amano, Jun

doi:10.1080/00365520252903170

Cited by 9 publications

(3 citation statements)

References 24 publications

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“…In addition, comparison of the groups with and without sedation revealed that the increments in serum cortisol, glucose and CRP levels were similar in both groups and that the values of the parameters obtained prior to and 10 min and 1 h after endoscopy were not statistically different between groups. These results agree with those reported by Yazawa et al (18), and suggest the view that sedation is not effective in reducing the endocrine response occurring during upper gastrointestinal endoscopy.…”

Section: Discussionsupporting

confidence: 92%

Effects of sedation during upper gastrointestinal endoscopy on endocrine response and cardiorespiratory function

Yetkın

Oba

Uludağ

et al. 2007

Braz J Med Biol Res

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Upper gastrointestinal endoscopy is often accompanied by tachycardia which is known to be an important pathogenic factor in the development of myocardial ischemia. The pathogenesis of tachycardia is unknown but the condition is thought to be due to the endocrine response to endoscopy. The purpose of the present study was to investigate the effects of sedation on the endocrine response and cardiorespiratory function. Forty patients scheduled for diagnostic upper gastrointestinal endoscopy were randomized into 2 groups. While the patients in the first group did not receive sedation during upper gastrointestinal endoscopy, the patients in the second group were sedated with intravenous midazolam at the dose of 5 mg for those under 65 years or 2.5 mg for those aged 65 years or more. Midazolam was administered by slow infusion. In both groups, blood pressure, ECG tracing, heart rate, and peripheral oxygen saturation (SpO 2 ) were monitored during endoscopy. In addition, blood samples for the determination of cortisol, glucose and C-reactive protein levels were obtained from patients in both groups prior to and following endoscopy. Heart rate and systolic arterial pressure changes were within normal limits in both groups. Comparison of the two groups regarding the values of these two parameters did not reveal a significant difference, while a statistically significant reduction in SpO 2 was found in the sedation group. No significant differences in serum cortisol, glucose or C-reactive protein levels were observed between the sedated and non-sedated group. Sedation with midazolam did not reduce the endocrine response and the tachycardia developing during upper gastrointestinal endoscopy, but increased the reduction in SpO 2 .

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Section: Discussionsupporting

confidence: 92%

Effects of sedation during upper gastrointestinal endoscopy on endocrine response and cardiorespiratory function

Yetkın

Oba

Uludağ

et al. 2007

Braz J Med Biol Res

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show abstract

“…Although many clinical trials have documented the feasibility of endoscopies without any sedation [3, 4, 5], and reduction of cardiac stress under sedation does not seem to be a strong argument [6, 7], given the choice, a majority of patients would undoubtedly prefer sedation [8]. Patients’ opinions probably depend not solely on their own personal experiences: the (poor) reputation of endoscopic procedures and patients’ fears have become a consideration in public health viz.…”

Section: Introductionmentioning

confidence: 99%

The Dawning of a New Sedative: Propofol in Gastrointestinal Endoscopy

Heuss

Inauen²

2004

Digestion

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Background: Using gentler endoscopes and improved sedation, great strides have been made in enhancing patients’ comfort and acceptance of endoscopic procedures. Because morbidity and mortality have been associated with benzodiazepines in endoscopic sedation, safer alternatives were sought. Propofol (2,6-diisopropylphenol), a rapid and short-acting anesthetic, initially used in the 1980’s for general anesthesia induction and maintenance, is a promising candidate. Methods: This review article examines experiences and literature references of propofol’s use in endoscopic procedures. Three critical questions are posed: What are the major advantages and potential risks of propofol? When should propofol be used? Who should administer propofol, how should it be administered, and what type of monitoring is required? Results: With considerable inter-patient variability, the propofol dose must be carefully titrated according to the individual patient’s response. Factors influencing dosage include age, ASA class, patient’s height and procedure duration. Propofol’s primary risk is its narrow therapeutic range which necessitates careful patient monitoring. Conclusions: Propofol’s advantages over benzodiazepines and narcotics include a more rapid onset of action, full relief of discomfort and rapid recovery to alertness without residual sedative effects or anterograde amnesia, thereby making this drug a cost-effective and, with proper monitoring, safe choice.

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“…Benzodiazepine combinations: Because midazolam does not exhibit any analgesic effects, sole use for conscious sedation does not suppress sympathic stimulation due to esophageal intubation [29]. In order to reduce the harmful effects of sympathic stimulation benzodiazepines are usually combined with opioids.…”

Section: Benzodiazepinsmentioning

confidence: 99%

Sedation for Esophagogastroduodenal Endoscopy

Aydın¹

2011

Ann Clin Anal Med

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ÖzetÖzefagogastroduedonal endoskopi sırasında pek çok anestetik yöntem ve ilaç kullanılabilir. Özefagogastroduedonal endoskopi için uygulanacak sedasyon ilaç ve yöntemleri hakkında araştırmalar sürmektedir. Bu derlemenin amacı sedasyon ve özefagogastroduedonal endoskopi ve sedasyonla ilişkili konuları literature bilgileri ışığında tartışmaktır. Tanısal özefagogastroduedonal endoskopi için günü-müzde kullanılan standart yöntem genellikle yüzeyel farengeal anestezi minimal sedasyon ya da anksiyolizdir. Gerekli olursa sonradan analjezi eklenebilir. Uzun süreli, karmaşık ya da sorunlu ve ağrılı işlemler için uzman denetiminde yapılan daha derin sedasyon yöntemleri gerekebilir. Anahtar KelimelerEndoskopi; Gastrointestinal Endoskopi; Sedasyon Abstract Different anesthetic techniques and drugs can be used for esophagogastroduedonal endoscopy. However, the scientists are still searching for appropriate drugs and protocols for sedation during esophagogastroduedonal endoscopy. The aim of this review is to discuss the topics related with sedation and esophagogastroduedonal endoscopy in the light of literature. Today standard procedure for diagnostic esophagogastroduedonal endoscopy usually consists of topical pharyngeal anesthesia, minimal sedation or anxiolysis, which may be complemented with analgesia when needed. When a prolonged, complex, or particularly troublesome or painful examination is foreseen, deeper sedation with multiple drugs and in closed observation of a staff may be required.

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Can Sedation Reduce the Cardiac Stress During Gastrointestinal Endoscopy? A Study With Non-invasive Automated Cardiac Flow Measurement by Color Doppler Echocardiography

Abstract: Conscious sedation with midazolam does not reduce the cardiac stress during UGIE.

Cited by 9 publications

References 24 publications

Effects of sedation during upper gastrointestinal endoscopy on endocrine response and cardiorespiratory function

Effects of sedation during upper gastrointestinal endoscopy on endocrine response and cardiorespiratory function

The Dawning of a New Sedative: Propofol in Gastrointestinal Endoscopy

Sedation for Esophagogastroduodenal Endoscopy

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