Propofol sedation with bispectral index monitoring is useful for endoscopic submucosal dissection: a randomized prospective phase II clinical trial

Sasaki, Takeshi; Tanabe, Satoshi; Azuma, Mizutomo; Satô, Akiko; Naruke, Akira; Ishido, Kenji; Katada, Chikatoshi; Higuchi, Katsuhiko; Koizumi, Wasaburo

doi:10.1055/s-0032-1306776

Cited by 42 publications

(53 citation statements)

References 20 publications

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“…Propofol sedation is widely used for gastrointestinal tract endoscopy in Western countries, but its use in endoscopic practices in Japan is uncommon, because administration of propofol by endoscopists is very restricted because of a government regulation and anesthesiologists rarely come to an endoscopy unit. However, we recognize the use seems to be convenient and safe from two studies [12,13]. The evidence will hopefully lead to common use of propofol sedation for, at least, therapeutic endoscopy, including gastric ESD, in Japan.…”

Section: Discussionmentioning

confidence: 96%

“…Two studies regarding propofol sedation (one RCT and one case series study) were identified [12,13]. Sasaki et al [12] revealed that propofol had modest advantages over midazolam in terms of safety and efficacy during ESD, but significantly earlier recovery from sedation was obtained in the propofol group.…”

Section: Preparation and Sedationmentioning

confidence: 99%

“…Sasaki et al [12] revealed that propofol had modest advantages over midazolam in terms of safety and efficacy during ESD, but significantly earlier recovery from sedation was obtained in the propofol group. Gotoda et al [13] reported possible safety and efficacy of gastroenterologist-guided propofol sedation even for elderly patients by retrospective medical record reviews.…”

Section: Preparation and Sedationmentioning

confidence: 99%

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Updated evidence on endoscopic resection of early gastric cancer from Japan

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Section: Discussionmentioning

confidence: 96%

Section: Preparation and Sedationmentioning

confidence: 99%

Section: Preparation and Sedationmentioning

confidence: 99%

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Updated evidence on endoscopic resection of early gastric cancer from Japan

et al. 2016

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“…The BIS is also used for sedation assessment in critically ill patients (11)(12)(13)(14)(15)(16). Although the BIS has not been developed for use in patients with neurologic disorders, some published studies have focused on brain injured patients (17)(18)(19)(20)(21)(22)(23)(24).…”

Section: Introductionmentioning

confidence: 99%

Prediction of neurological outcome using bispectral index in patients with severe acute brain injury

Wang¹,

Zhang²,

Wu³

2013

Turk J Med Sci

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To predict consciousness recovery and outcome of patients with severe acute brain injury using the bispectral index (BIS). Materials and methods:A prospective study of 189 brain-injured patients was made when they were without sedatives for at least 24 h. BIS, 95% spectral edge frequency (SEF), burst suppression ratio (SR), total power (TP), spontaneous electromyographic activity (EMG), and signal quality index (SQI) were recorded continuously for 30 min. Neurologic conditions were measured with the Glasgow Coma Score (GCSBIS) when recording BIS. Patients were followed for 30 days after injury to assess consciousness recovery and outcome.Results: There were statistically significant differences in BIS measurements between patients that recovered consciousness or survived and those who did not. The best correlation coefficients for patients' outcome were 0.738 for GCSBIS, 0.639 for SR, and 0.591 for BIS. As to the patients' consciousness recovery, the best coefficients were 0.656 for GCSBIS, 0.526 for BIS, and 0.511 for SR. According to the area under the receiver operating characteristic curve, the best values to predict consciousness recovery and survival were GCSBIS and BIS, and for unconsciousness and death, the best parameters were SR, APACHE II score, and SEF. Conclusion:BIS measurement is useful to predict consciousness recovery and outcome in severe acute brain injury.

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“…The bispectral index (BIS), an objective assessment tool for the prevention of intraoperative awareness during general anesthesia, has also recently been used to evaluate sedation levels. [6][7][8][9] However, mainly because of the high cost of BIS, it is not standard equipment for sedation during dental treatment.…”

mentioning

confidence: 99%

Female Patients Require a Higher Propofol Infusion Rate for Sedation

Miyagawa

Higuchi

Honda

et al. 2016

Anesthesia Progress

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Sedation may minimize physiologic and behavioral stress responses. In our facility, the infusion rate of propofol is adjusted according to the bispectral index (BIS) in all cases of implant-related surgery; multivariate analysis of retrospective data enabled us to extract independent factors that affect the dose of propofol in sedation that are considered useful indicators for achieving adequate sedation. The study population comprised all patients undergoing implant-related surgery under intravenous sedation in Okayama University Hospital from April 2009 to March 2013. The infusion rate of propofol was adjusted to maintain the BIS value at 70-80. The outcome was the average infusion rate of propofol, and potential predictor variables were age, sex, body weight, treatment time, and amount of midazolam. Independent variables that affected the average infusion rate of propofol were extracted with multiple regression analysis. One hundred twenty-five subjects were enrolled. In the multiple regression analysis, female sex was shown to be significantly associated with a higher average infusion rate of propofol. Females may require a higher infusion rate of propofol than males to achieve adequate sedation while undergoing implant-related surgery.

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Propofol sedation with bispectral index monitoring is useful for endoscopic submucosal dissection: a randomized prospective phase II clinical trial

Abstract: Propofol with BIS monitoring improved recovery of patients after ESD, though this study was underpowered to prove the effectiveness and safety of propofol.

Cited by 42 publications

References 20 publications

Updated evidence on endoscopic resection of early gastric cancer from Japan

Updated evidence on endoscopic resection of early gastric cancer from Japan

Prediction of neurological outcome using bispectral index in patients with severe acute brain injury

Female Patients Require a Higher Propofol Infusion Rate for Sedation

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