Intermittent manually controlled versus continuous infusion of propofol for deep sedation during interventional endoscopy: A prospective randomized trial

Riphaus, A.; Geist, Christoph; Schrader, Katrin; Martchenko, Ksenia; Wehrmann, T.

doi:10.3109/00365521.2012.685758

Cited by 41 publications

(40 citation statements)

References 36 publications

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“…Continuous infusion via a perfusor pump may be preferable to take advantage of propofol pharmacokinetics in order to maintain a constant sedation level, so that we can avoid the peaks and valleys of the propofol plasma concentration once achieved the desired target of sedation and minimizing the risk of propofol overdosing as well. In this regard, NAAP through PCI may fit especially with endoscopic procedures longer than colonoscopy, such as endoscopic ultrasonography or endoscopic retrograde cholangiopancreatography, as recently shown (15). Of note, similar results than ours were obtained in this study when comparing both ways of administering propofol, titrated to deep sedation, for interventional endoscopy.…”

Section: Discussionsupporting

confidence: 73%

Intermittent boluses versus pump continuous infusion for endoscopist-directed propofol administration in colonoscopy

González-Santiago

Martín-Noguerol

Vinagre-Rodríguez

et al. 2013

Rev. esp. enferm. dig.

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Background: non-anesthesiologist administration of propofol (NAAP) using continuous infusion systems may achieve a more sustained sedative action.Aim: to compare intermittent boluses (IB) with pump continuous infusion (PCI) for NAAP, targeted to moderate sedation, for colonoscopy.Methods: 192 consecutive outpatients were randomized to receive IB (20 mg propofol boluses on demand) or PCI (3 mg/ kg/h plus 20 mg boluses on demand). Sedation could be stopped at cecal intubation at the discretion of the endoscopist. Satisfaction rates of the patient, nurses and endoscopist, propofol doses, depth of sedation (at the beginning, at cecal intubation and at the end), recovery times, complications and were collected.Results: there were no differences between groups regarding patient, nurse or endoscopist satisfaction rates with procedural sedation. Propofol doses (mg) were significantly higher during the induction phase (86 [30-172] vs. 78 [30-160], p 0.03) and overall (185 [72-400] vs. 157 [60-460], p = 0.003) for PCI group. 81 % of assessments of the depth of sedation were moderate. The level of sedation (O/AAS scale) was borderline significantly deeper at cecal intubation (2.38 vs. 2.72; p = 0.056) and at the end of the procedure (4.13 vs. 4.45; p = 0.05) for PCI group, prolonging thus early recovery time (6.3 vs. 5.1 minutes, p = 0.008), but not discharge time. Complications, all of them in minors, were non-significantly more frequent in the PCI group (9 vs. 7 %, p = 0.07).Conclusions: NAAP for colonoscopy was safely administered with comparable satisfaction and complication rates with either IB or PCI.

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Section: Discussionsupporting

confidence: 73%

Intermittent boluses versus pump continuous infusion for endoscopist-directed propofol administration in colonoscopy

González-Santiago

Martín-Noguerol

Vinagre-Rodríguez

et al. 2013

Rev. esp. enferm. dig.

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“…Our results are in line with the results by González-Santiago et al [20] and Riphaus et al [21]. The aim of those studies was to investigate safety, quality of sedation, and recovery time from propofol sedation.…”

Section: Discussionsupporting

confidence: 82%

“…On the other hand, the satisfaction of the patients, nurses, and endoscopists with the sedation has not been studied for the different sedation regimens. Riphaus et al [21] showed comparable satisfaction rates for patients, nurses, and endoscopists in both groups. A possible intention to achieve a more sustained sedative effect by maintaining a preset concentration of propofol in the blood or brain, providing a higher patient satisfaction with the procedural sedation was not approved.…”

Section: Discussionmentioning

confidence: 99%

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Continuous propofol and bolus propofol result in similar sedative use during endoscopic retrograde cholangiopancreatography: A retrospective study

Seyitoglu¹,

İskender²,

Azzarok³

et al. 2017

Gastroenterol Hepatol Endosc

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“…The published protocols for continuous propofol infusion states are 2 to 5 mg/kg/hr (or 100 to 200 mg/hr), sometimes with an initial 0.25 to 0.5 mg/kg bolus 9,21,22,23. Although continuous infusion of propofol by a pump is widely used in anesthesia practice and the pumps are easily programmed, most nonanesthesiologists prefer the flexibility of the bolus approach 9,21…”

Section: Sedation Regimens For Endoscopists In Actual Practicementioning

confidence: 99%

Sedation Regimens for Gastrointestinal Endoscopy

Moon

2014

Clin Endosc

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Sedation allows patients to tolerate unpleasant endoscopic procedures by relieving anxiety, discomfort, or pain. It also reduces a patient's risk of physical injury during endoscopic procedures, while providing the endoscopist with an adequate setting for a detailed examination. Sedation is therefore considered by many endoscopists to be an essential component of gastrointestinal endoscopy. Endoscopic sedation by nonanesthesiologists is a worldwide practice and has been proven effective and safe. Moderate sedation/analgesia is generally accepted as an appropriate target for sedation by nonanesthesiologists. This focused review describes the general principles of endoscopic sedation, the detailed pharmacology of sedatives and analgesics (focused on midazolam, propofol, meperidine, and fentanyl), and the multiple regimens available for use in actual practice.

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Intermittent manually controlled versus continuous infusion of propofol for deep sedation during interventional endoscopy: A prospective randomized trial

Abstract: Both sedation regimens allow nearly identical good controllability of propofol sedation. However, recovery time was significantly slower and hypotension was tended to occur more often in the perfusor group.

Cited by 41 publications

References 36 publications

Intermittent boluses versus pump continuous infusion for endoscopist-directed propofol administration in colonoscopy

Intermittent boluses versus pump continuous infusion for endoscopist-directed propofol administration in colonoscopy

Continuous propofol and bolus propofol result in similar sedative use during endoscopic retrograde cholangiopancreatography: A retrospective study

Sedation Regimens for Gastrointestinal Endoscopy

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