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Titolo:
Intravenous sedation with propofol during endoscopic sphincter of Oddi manometry
Autore:
Schmitt, T; Seifert, H; Dietrich, CF; Caspary, WF; Wehrmann, T;
Indirizzi:
Univ Frankfurt Klinikum, Med Klin 2, D-60590 Frankfurt, Germany Univ Frankfurt Klinikum Frankfurt Germany D-60590 590 Frankfurt, Germany
Titolo Testata:
ZEITSCHRIFT FUR GASTROENTEROLOGIE
fascicolo: 3, volume: 37, anno: 1999,
pagine: 219 - 227
SICI:
0044-2771(199903)37:3<219:ISWPDE>2.0.ZU;2-E
Fonte:
ISI
Lingua:
GER
Soggetto:
CONSCIOUS SEDATION; MIDAZOLAM-FENTANYL; COLONOSCOPY; MEPERIDINE; MOTILITY; DIAZEPAM; PREMEDICATION; ANESTHESIA; FLUMAZENIL; PRESSURE;
Keywords:
midazolam; propofol; sphincter of Oddi motility; manometry; sphincter of Oddi dysfunction;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
43
Recensione:
Indirizzi per estratti:
Indirizzo: Wehrmann, T Univ,Frankfurt Klinikum, Med Klin 2, Theodor Stern Kai 7, D-60590 Frankfurt Univ Frankfurt Klinikum Theodor Stern Kai 7 Frankfurt Germany D-60590
Citazione:
T. Schmitt et al., "Intravenous sedation with propofol during endoscopic sphincter of Oddi manometry", Z GASTROENT, 37(3), 1999, pp. 219-227

Abstract

Endoscopic manometry of the sphincter Oddi (SO) is a sophisticated method which requires a cooperative patient. Therefore, during endoscopic manometry sufficient i. v. sedation is crucial, and additionally must no affect SO-motility. In a pilot trial SO-motility was determined in ten patients with suspectedSO-dysfunction (SOD) under initial sedation with 4,8 +/- 1 mg midazolam (baseline), and 3 min after an i. v. bolus of 50 mg of propofol. In addition,endoscopic manometry was performed in 57 consecutive patients with suspected SOD from 10/94-9/95 under sedation with midazolam (6,2 +/- 1.6 mg); and from 10/95-9/96 with propofol (268 +/- 111 mg). Sedation was always performed by an independent physician according to a standardized protocol. Neither the SO-baseline pressure nor the parameters of phasic SO-motility were significantly altered by propofol (including two patients with proven SOD). Propofol causes a more rapid onset of sedation, and the time intervalto oh tain successful biliary cannulation was shorter than under midazolam(p < 0,05). Successful manometric recordings could be obtained in 82% of the patients under midazolam but in 96% of the patients under propofol-sedation (p < 0,05); respectively. The patient cooperation was significantly better rated (by the endoscopist) in the propofol group than in the midazolam group (p < 0,01). The blood pressure and the heart rate were not significantly affected in both groups, however, propofol caused a significant decrease of the oxygen saturation (p< 0,05). Accordingly, an apnea episode had to be mastered by mask ventilation via ambu ba in one patient under propofol-sedation (uneventful recovery). In the midazolam group flumazenil-adminstration was necessary in four patients. The post-procedure recovery was faster after propofol - than after midazolam-sedation (p < 0,05). In conclusion, propofol is suitable for i. v. sedation during endoscopic manometry of the spincter of Oddi.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 05/07/20 alle ore 07:33:46