Efficacy of carbon dioxide versus air insufflation according to different sedation protocols during therapeutic endoscopic retrograde cholangiopancreatography: <scp>P</scp>rospective, randomized, double‐blind study

Lee, Su Jin; Lee, Tae Hoon; Park, Sang‐Heum; Lee, Yun Nah; Jung, Yunho; Choi, Hyun Jong; Cha, Sang‐Woo; Moon, Jong Ho; Cho, Young Deok; Kim, Sun‐Joo

doi:10.1111/den.12448

Cited by 8 publications

(17 citation statements)

References 21 publications

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“…The frequency of hypoxia was not different between the two groups. However, the frequency of hypoxia (15%) was higher than that in our previous study (2.9–10%), and no serious complications or permanent interruption of the procedures occurred . Increased O 2 supply during sedation was more frequent in the PF group, albeit not significantly so.…”

Section: Discussioncontrasting

confidence: 67%

“…Based on this and our previous studies, midazolam‐based sedation with fentanyl may be recommended for safe endoscopic sedation given by non‐anesthesiologists in patients over 80 years of age. Midazolam‐based sedation showed the same sedation quality and satisfaction as those of propofol‐based sedation, with the exception of recovery time.…”

Section: Discussionmentioning

confidence: 67%

“…In the general population, endoscopic sedation based on balanced propofol sedation during therapeutic ERCP showed better sedation efficacy in terms of improved patient cooperation and patient satisfaction and decreased recovery time, compared with propofol monosedation. There was no significant difference in the rates of adverse events . Therefore, propofol‐based sedation was more efficacious with a similar safety profile during advanced endoscopic procedures compared with midazolam‐based sedation.…”

Section: Discussionmentioning

confidence: 84%

“…However, the method of endoscopic sedation differs according to country, health‐care system, cost, and preference. In general, propofol‐based sedation exhibits adverse event rates similar to those of benzodiazepines and provides better sedation quality, greater patient cooperation, and higher post‐procedural patient satisfaction for most endoscopic procedures . In addition, for advanced endoscopic procedures, compared with sedation by an anesthesiologist, NAAP has a similar level of safety but potentially lower patient and endoscopist satisfaction .…”

Section: Discussionmentioning

confidence: 99%

“…Conscious sedation by NAAP has been reported to be safe and tolerable, as well as less costly. 6,16,[18][19][20] However, an adequate sedation protocol for patients over 80 years of age is still required under non-anesthesiologist directed sedation.…”

Section: Introductionmentioning

confidence: 99%

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Efficacy of midazolam‐ versus propofol‐based sedations by non‐anesthesiologists during therapeutic endoscopic retrograde cholangiopancreatography in patients aged over 80 years

Han

Lee

Park

et al. 2017

Digestive Endoscopy

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Background and Aim: As society ages, the need for endoscopic retrograde cholangiopancreatography (ERCP) is increasing. This prospective comparative study evaluated the safety and efficacy of midazolam-versus propofol-based sedations by non-anesthesiologists during therapeutic ERCP in patients over 80 years of age. Methods:A total of 100 patients over 80 years of age who required therapeutic ERCP were enrolled and randomly received midazolam + fentanyl (MF group) or propofol + fentanyl (PF group) sedation. Endoscopic sedation was titrated to a moderate level and carried out by trained registered nurses. Main outcome measurements were sedation safety in terms of cardiopulmonary components and efficacy measured on a 10-point visual analogue scale (VAS).Results: Regarding safety, hypoxia occurred in seven (14%) in the MF group and in eight patients (16%) in the PF group (P = 0.779). Increased O 2 supply was more frequent in the PF group (32% vs 42%), albeit not significantly so. There were no differences in the frequency of hypotension, bradycardia or tachycardia between the two groups. Mean VAS score for overall satisfaction with sedation by patients, endoscopists, and nurses and the scores for pain during the procedures were not different between the two groups. There was no significant difference in the procedure outcomes or rate of ERCP-related complications.Conclusions: There were no significant differences of safety and efficacy between midazolam-and propofol-based sedation in patients over 80 years of age. Increased O 2 supply was more frequent in the propofol group, but the prevalence of hypoxia did not differ significantly.

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Section: Discussioncontrasting

confidence: 67%

Section: Discussionmentioning

confidence: 67%

Section: Discussionmentioning

confidence: 84%

Section: Discussionmentioning

confidence: 99%