Propofol Target-controlled Infusion in Anesthesia Induction during Painless Gastroscopy

Li, Dongni; Zhao, Guoqing; Su, Zhenbo

doi:10.29271/jcpsp.2019.07.604

Cited by 12 publications

(11 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…One important reason was the inhibition of the cardiovascular system by fentanyl analgesics such as propofol and remimazolam, which is related to their pharmacological properties. However, there is a greater decrease in the propofol combined with the alfentanil group, which indicates that RB has a less cardiovascular effect than propofol, and the changes of HR, BP are relatively stable, which is also consistent with the conclusions of previous drug clinical trials [13].…”

Section: Introductionsupporting

confidence: 86%

Efficacy and Safety of Remimazolam Besylate Combined with Alfentanil in Painless Gastroscopy: A Randomized, Single‐Blind, Parallel Controlled Study

Chen

Ren

et al. 2022

Contrast Media & Molecular Imaging

View full text Add to dashboard Cite

Background. The efficacy and adverse reactions of remimazolam besylate (RB) in combination with alfentanil in patients with painless gastroscopy remain unclear. Objective. The aim of the study is to observe the efficacy and adverse reactions of RB in combination with alfentanil in patients with painless gastroscopy RB. Methods. All patients were randomly divided into two groups: RB combined with the alfentanil group (research group) and propofol combined with the alfentanil group (control group). After full oxygen inhalation and electrocardiographic monitoring, the research group was given 10 μg/Kg alfentanil + RB 0.2 mg/kg intravenously, and the control group was given 10 μg/Kg alfentanil + propofol 1.5 mg/kg. If there is a clinical need, the research group was given 2.5 mg/additional RB, whereas the control group was treated with an additional 0.5 mg/kg propofol. Main outcome measures were as follows: The vital endpoints including diachronic changes in heart rate (HR), blood pressure (BP), respiratory rate (RR), blood oxygen saturation (SPO2), end-expiratory carbon dioxide (etCO2), IPI, modified observer’s assessment of alert/sedation (MOAA/S), time-related endpoints, perioperative adverse events, endoscopy, and anesthesiologist satisfaction, and 24-hour follow-up of adverse reactions, IPI scores, and satisfaction were recorded. Results. The HR and BP of the patients in the research group and the control group decreased, with a greater decrease in the control group, and the difference was statistically significant ( p < 0.05). The values of RR, PETCO2, and IPI in the research group and the control group decreased to the lowest at 2–3 min but the decrease in the control group was more significant. Furthermore, there was no significant difference in the time from the completion of administration to 4 minutes of IPI and the total examination time, but the awakening time in the research group was slightly longer than that in the control group, and the difference was statistically significant ( p < 0.05). The incidences of respiratory depression and hypotension during the operation were shown to be markedly smaller in the investigation relative to the control team, and the difference was statistically significant ( p < 0.05), whereas the occurrence of cough, movements, and singultus was more common in the investigations, and the difference was statistically significant ( p < 0.05). The results of the 24-hour follow-up showed that the adverse reactions such as nausea, dizziness, fatigue, abdominal pain, and abdominal distension were much less frequent in the study team, and the difference was statistically significant ( p < 0.05), and the patient satisfaction was higher than in the control group, and the difference was statistically significant ( p < 0.05). The regression results showed that age, sedative, and total dose of analgesia had significant effects on the results, and the covariance coefficient of sedative was 1.57 of IPI score in the research group higher than that of the control group. Conclusions. RB combined with alfentanil can provide safe and effective sedation for patients undergoing painless gastroscopy. Compared with propofol, RB and alfentanil for injection can avoid large hemodynamic fluctuations and deep sedation, and have fewer adverse reactions. However, the cases involved in this study are all from a single-center data, which requires further multicenter research and conformation.

show abstract

Section: Introductionsupporting

confidence: 86%

Efficacy and Safety of Remimazolam Besylate Combined with Alfentanil in Painless Gastroscopy: A Randomized, Single‐Blind, Parallel Controlled Study

Chen

Ren

et al. 2022

Contrast Media & Molecular Imaging

View full text Add to dashboard Cite

show abstract

“…(1) e inclusion criteria include the following: those who met the indications for painless gastroenteroscopy; all were 20 to 75 years old and patients had no allergies or contraindications to any of the drugs associated with this study. (2) e exclusion criteria include the following: patients with potentially life-threatening circulatory and respiratory diseases which had not been adequately controlled; hepatic dysfunction (Child-Pugh class C or higher); coagulation disorders; cognitive dysfunction; and pregnant and lactating women. All study subjects were divided into a control group (n � 53 cases) and an observation group (n � 53 cases) using the random-number table method, and there was no statistical difference between the two groups compared with each other in terms of baseline information such as sex, age, BMI, and the American Society of Anesthesiology (ASA) classification (P > 0.05), see Table 1 for details.…”

Section: Patients' General Informationmentioning

confidence: 99%

Effects of Remimazolam Combined with Esketamine Anesthesia on Circulatory and Respiratory Function during Painless Gastroenteroscopy

Guo

Jiang

2022

Contrast Media & Molecular Imaging

View full text Add to dashboard Cite

Objective. To investigate the effect of applying remimazolam combined with esketamine for anesthesia in painless gastroenteroscopy on patients’ circulatory and respiratory function. Method. In this study, 106 patients who had undergone painless gastroenteroscopy in Xinjiang Production and Construction Corps (XPCC) Hospital between July 2021 and January 2022 were selected as study subjects, which were grouped according to the anesthetic drugs used in the surgery and divided into control group (n = 53 cases) and observation group (n = 53 cases), while those who were anesthetized with propofol + sufentanil during the operation were the control group and those who were anesthetized with remimazolam + esketamine were the observation group. To compare the induction time of anesthesia, patient awakening and recovery time of orientation, circulatory and respiratory function, intraoperative adverse effects, and postoperative complications in the two study groups. Results. There was no statistical difference in induction of anesthesia, patient awakening, and recovery time of orientation between the two groups ( P > 0.05 ) and no statistical difference in postoperative complications ( P > 0.05 ). The observation group had a better occurrence of local pain at the injection site, circulatory and respiratory function of patients after anesthesia, and intraoperative adverse reactions than the control group ( P < 0.05 ). Conclusion. Remimazolam combined with esketamine anesthesia has the same advantages of rapid awakening compared with propofol anesthesia. Moreover, it has fewer side effects on patients’ circulatory and respiratory functions with fewer adverse effects, as a suitable anesthetic method for painless gastroenteroscopy.

show abstract

“…1 As indicated in a large randomized controlled trial, the prevalence of hypoxemia in patients after intravenous (IV) injection of propofol was 20% during painless colonoscopy. 2 Studies have shown that the heavier the bodyweight, the higher the prevalence of hypoxemia. 3 In addition, the high prevalence of hypoxemia may be associated with mortality, myocardial ischemia, brain injury, and the risk of mechanical ventilation.…”

Section: Introductionmentioning

confidence: 99%

<p>Application of Intravenous Lidocaine in Obese Patients Undergoing Painless Colonoscopy: A Prospective, Randomized, Double-Blind, Controlled Study</p>

Li¹,

Lv²,

Jiang³

et al. 2020

DDDT

View full text Add to dashboard Cite

Propofol for procedural sedation and analgesia (PSA) for colonoscopy can result in a high prevalence of severe respiratory depression. Studies have shown that intravenous (IV) infusion of lidocaine can reduce propofol requirements significantly and increase the ventilatory response to carbon dioxide in humans. We tested the hypothesis that IV lidocaine could improve propofol-induced respiratory depression in obese patients during colonoscopy. Methods: Ninety obese patients scheduled for painless colonoscopy were randomized to receive lidocaine (1.5 mg/kg, then 2 mg/kg/h, IV) or the same volume of 0.9% saline. Intraoperative sedation was provided by propofol. The primary outcome was the number of oxygen-desaturation episodes. Secondary outcomes were: the number of apnea episodes; total propofol consumption; time to the first hypoxia episode; time to consciousness loss; intraoperative hemodynamic parameters; awakening time; adverse events; duration of postanesthesia care unit (PACU) stay; satisfaction of endoscopists and patients. Results: Demographic characteristics between the two groups were comparable. The number of oxygen-desaturation episodes in group L (1.49±1.12) decreased by 0.622 (P=0.018) compared with that in group N (2.11±1.32), and the number of apnea episodes in group L decreased by 0.533 (P<0.001). Kaplan-Meier curves showed that the median time to the first hypoxia episode was longer in group L (86.78 s) than that in group N (63.83 s) (Log rank P=0.0008). The total propofol consumption, awakening time, and duration of PACU stay were reduced in group L. There was no significant difference in the prevalence of adverse events (P>0.05 for all). Satisfaction scores for endoscopists and patients in group L were higher than that in group N (P<0.001). Conclusion: Intravenous infusion of lidocaine could significantly reduce the number of oxygen-desaturation and apnea episodes in obese patients during painless colonoscopy. This method is worthy of clinical promotion. Clinical Trials Registration: ChiCTR2000028937.

show abstract

Propofol Target-controlled Infusion in Anesthesia Induction during Painless Gastroscopy

Abstract: Board and written informed consent was obtained from all participating subjects. A total of 180 patients with American Society of Anesthesiologists (ASA) I-II, who were scheduled to receive painless fibergastroscopic diagnosis or treatment in

Cited by 12 publications

References 19 publications

Efficacy and Safety of Remimazolam Besylate Combined with Alfentanil in Painless Gastroscopy: A Randomized, Single‐Blind, Parallel Controlled Study

Efficacy and Safety of Remimazolam Besylate Combined with Alfentanil in Painless Gastroscopy: A Randomized, Single‐Blind, Parallel Controlled Study

Effects of Remimazolam Combined with Esketamine Anesthesia on Circulatory and Respiratory Function during Painless Gastroenteroscopy

<p>Application of Intravenous Lidocaine in Obese Patients Undergoing Painless Colonoscopy: A Prospective, Randomized, Double-Blind, Controlled Study</p>

Contact Info

Product

Resources

About