The hemodynamic effect of an intravenous antispasmodic on propofol requirements during colonoscopy: A randomized clinical trial

Pao, Y S; Chung, Kuan‐Chih; Chen, Ju-Pin; Lee, Ko‐Chao; Hu, Wan-Hsiang; Juang, Sin-Ei; Lu, Hsin-Chun; Tan, Ping-Heng; Hung, Kuo‐Chuan

doi:10.1016/j.aat.2014.05.003

Cited by 6 publications

(4 citation statements)

References 28 publications

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“…However, only a few reports have described propofol TCI technique in sedation for GI endoscopy. Hsu et al [13] and Pao et al [15] described propofol TCI during colonoscopy and/or upper GI endoscopy in a Taiwanese population. The former also revealed that propofol at low Ce (1.5–2.5 mg/mL) is effective and has fewer cardiovascular events [15].…”

Section: Discussionmentioning

confidence: 99%

“…Hsu et al [13] and Pao et al [15] described propofol TCI during colonoscopy and/or upper GI endoscopy in a Taiwanese population. The former also revealed that propofol at low Ce (1.5–2.5 mg/mL) is effective and has fewer cardiovascular events [15]. Another report revealed that propofol TCI provided excellent sedation and reduced severe cardiovascular and respiratory depression than did intermittent bolus propofol with midazolam/alfentanil regimen [14].…”

Section: Discussionmentioning

confidence: 99%

“…Theoretically, TCI provides a more precise control of propofol concentration than the intermittent bolus methods, which result in many peaks and troughs of propofol level. Only limited reports have investigated propofol TCI in sedated GI endoscopy [13–15]; instead, propofol was administrated by intermittent bolus methods in most nonanesthesiologist practices [16,17].…”

Section: Introductionmentioning

confidence: 99%

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Propofol target‐controlled infusion for sedated gastrointestinal endoscopy: A comparison of propofol alone versus propofol–fentanyl–midazolam

Hsu

Huang

Chuang

et al. 2015

The Kaohsiung J of Med Scie

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Gastrointestinal (GI) endoscopy is the major technique for diagnosis of GI disease and treatment. Various sedation and analgesia regimens such as midazolam, fentanyl, and propofol can be used during GI endoscopy. The purpose of the study was to compare propofol alone and propofol combination with midazolam and fentanyl in moderate sedation for GI endoscopy. One hundred patients undergoing GI endoscopy were enrolled in this study. All patients received a propofol target-controlled infusion (TCI) to maintain sedation during the procedure. Patients were randomly allocated into either Group P (propofol TCI alone) or Group C (combination of propofol TCI plus midazolam and fentanyl). Dermographic data, anesthetic parameters (sedation regimen, blood pressure, heart rate, and oxygen saturation), procedure parameters (procedure time, colonoscopy, or panendoscopy), propofol consumption, and adverse events (hypoxia, hypotension, and bradycardia) were all recorded. Postprocedural records included recovery time, postoperative adverse events (nausea, vomiting, dizziness, recall, and pain) and satisfaction. The average propofol consumption was 251 ± 83 mg in Group P and 159 ± 73 mg in Group C (p < 0.001). The incidence of transient hypotension was higher in Group P (p = 0.009). The recovery time and discharge time were both shorter in Group C (p < 0.001 and p = 0.006 respectively). Overall, postprocedural adverse events were similar in both groups. The postanesthetic satisfaction was comparable in both groups. TCI of propofol combined with midazolam and fentanyl achieved sedation with fewer hypotension episodes and shorter recovery and discharge time than propofol TCI alone in patients undergoing GI endoscopy.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Propofol target‐controlled infusion for sedated gastrointestinal endoscopy: A comparison of propofol alone versus propofol–fentanyl–midazolam

Hsu

Huang

Chuang

et al. 2015

The Kaohsiung J of Med Scie

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“…The presence of cardiac disease is a commonly cited contraindication to the use of HBB. The increase in heart rate induced by HBB [Gitanjali et al 1998; Pao et al 2014] theoretically has potential to exacerbate cardiac conditions such as atrial tachyarrhythmias, congestive cardiac failure, coronary artery disease and mitral stenosis. However, since the duration of action of HBB is short, this is unlikely to be of concern in the majority of these patients.…”

Section: Overview Of Antispasmodic Agentsmentioning

confidence: 99%

Antispasmodic drugs in colonoscopy: a review of their pharmacology, safety and efficacy in improving polyp detection and related outcomes

Sanagapalli

Agnihotri

Leong

et al. 2016

Therap Adv Gastroenterol

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Antispasmodic drugs are cheap, effective and generally safe. They may improve outcomes in colonoscopy, however their use has not been consistent or widespread. This manuscript reviews the three most commonly used antispasmodics in colonoscopy, namely, hyoscine butylbromide (and related ammonium compounds), glucagon and peppermint oil. The pharmacology, action and safety of the agents, as well as the evidence for them improving colonoscopic outcomes will be discussed. In addition to polyp detection, other colonoscopic outcome endpoints of interest include cecal and ileal intubation, and patient comfort. The drugs studied were all found to be effective gastrointestinal antispasmodics with good safety profiles. There is insufficient evidence to conclude whether antispasmodics improve cecal intubation rate, predominantly because the baseline rates are already high. Antispasmodics probably have efficacy in reducing cecal intubation time especially in those with marked colonic spasm. Antispasmodics do not offer significant benefit in polyp detection or improving patient comfort during colonoscopy. Future studies should focus on inexperienced colonoscopists as well as those with marked colonic spasm, in whom the greatest benefit seems to lie.

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Effect of intravenous lidocaine on outcomes in patients receiving propofol for gastrointestinal endoscopic procedures: an updated systematic review and meta-analysis

Wu,

Zhan,

et al. 2023

Eur J Clin Pharmacol

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The hemodynamic effect of an intravenous antispasmodic on propofol requirements during colonoscopy: A randomized clinical trial

Cited by 6 publications

References 28 publications

Propofol target‐controlled infusion for sedated gastrointestinal endoscopy: A comparison of propofol alone versus propofol–fentanyl–midazolam

Propofol target‐controlled infusion for sedated gastrointestinal endoscopy: A comparison of propofol alone versus propofol–fentanyl–midazolam

Antispasmodic drugs in colonoscopy: a review of their pharmacology, safety and efficacy in improving polyp detection and related outcomes

Effect of intravenous lidocaine on outcomes in patients receiving propofol for gastrointestinal endoscopic procedures: an updated systematic review and meta-analysis

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