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Titolo:
Efficacy and safety of intravenous propofol sedation during routine ERCP: a prospective, controlled study
Autore:
Wehrmann, T; Kokabpick, S; Lembcke, B; Caspary, WF; Seifert, H;
Indirizzi:
JW Goethe Univ Hosp, Dept Internal Med 2, D-60590 Frankfurt, Germany JW Goethe Univ Hosp Frankfurt Germany D-60590 D-60590 Frankfurt, Germany
Titolo Testata:
GASTROINTESTINAL ENDOSCOPY
fascicolo: 6, volume: 49, anno: 1999,
pagine: 677 - 683
SICI:
0016-5107(199906)49:6<677:EASOIP>2.0.ZU;2-D
Fonte:
ISI
Lingua:
ENG
Soggetto:
CONSCIOUS SEDATION; MIDAZOLAM-FENTANYL; HUMAN SPHINCTER; COLONOSCOPY; MEPERIDINE; ENDOSCOPY; DIAZEPAM; ODDI; PREMEDICATION; COMBINATION;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
28
Recensione:
Indirizzi per estratti:
Indirizzo: Wehrmann, T JWkfurt,e Univ Hosp, Dept Internal Med 2, Theodor Stern Kai 7,D-60590 Fran JW Goethe Univ Hosp Theodor Stern Kai 7 Frankfurt Germany D-60590
Citazione:
T. Wehrmann et al., "Efficacy and safety of intravenous propofol sedation during routine ERCP: a prospective, controlled study", GASTROIN EN, 49(6), 1999, pp. 677-683

Abstract

Background: Adequate patient sedation is mandatory for diagnostic and therapeutic endoscopic retrograde cholangiopancreatography (ERCP). The short-acting anesthetic propofol offers certain potential advantages for endoscopicprocedures, but controlled studies proving its superiority over benzodiazepines for ERCP are lacking. Methods: During a 6-month period 198 consecutive patients undergoing routine ERCP randomly received either midazolam (n = 98) or propofol (n = 99) for sedation. Vital signs (heart rate, blood pressure, oxygen saturation) were continuously monitored and procedure-related parameters, the recovery time and quality (recovery score) as well as the patient's cooperation and tolerance of the procedure (visual analog scales) were prospectively assessed. Results: Patients receiving propofol or midazolam were well matched with respect to demographic and clinical data, ERCP findings, and the performanceof associated procedures. Propofol caused a more rapid onset of sedation than midazolam (p < 0.01). Clinically relevant changes in vital signs were observed at comparable frequencies with temporary oxygen desaturation occurring (< 85%) in 6 patients in the propofol group and 4 patients receiving midazolam (not significant). However, an episode of apnea had to be managed by mask ventilation via an ambu bag (lasting 8 minutes) in one of the patients receiving propofol sedation. Mean recovery times as well as the recoveryscores were significantly shorter with propofol (p < 0.01). Propofol provided significantly better patient cooperation than midazolam (p < 0.01), butprocedure tolerability was rated the same by both groups of patients (not significant). Conclusions: Intravenous sedation with propofol for ERCP is (1) more effective than sedation with midazolam, (2) safe under adequate patient monitoring, and (3) associated with a faster postprocedure recovery.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 04/07/20 alle ore 05:02:27