engleski

Clinical analysis of propofol deep sedation for 1, 104 patients undergoing gastrointestinal endoscopic procedures : A three year prospective study

The optimal administration of conscious sedation and patient monitoring during gastrointestinal endoscopy has not been well emphasized. Benzodiazepines are most commonly used, often with pethidine. Anesthetic agents are less frequently used because oversedation may induce respiratory depression, hypotension, and other cardiopulmonary complications. In this study we analysed the hemodynamic and respiratory effects of propofol on patients undergoing gastroscopy and colonoscopy. In this prospective study, conducted over a period of three years, 1, 104 patients referred for a same day GI endoscopy procedure were analyzed. All patients were given a propofol bolus (0.5-1.5 mg/kg). Arterial blood pressure (BP) was monitored at 3 min intervals and heart rate and oxygen saturation (SpO2) were recorded continuously by pulse oximetry. Analyzed data acquisition was carried out before, during, and after the procedure. A statistically significant reduction in mean arterial pressure was demonstrated (p<0.001) when compared to pre-intervention values, but severe hypotension, defined as a systolic blood pressure below 60 mmHg, was noted in only 5 patients (0.5%). Oxygen saturation decreased from 96.5% to 94.4 % (p<0.001). A critical decrease in oxygen saturation (<90%) was documented in 27 patients (2.4%). Our results showed that propofol provided good sedation with excellent pain control, a short recovery time and no significant hemodynamic side effects. All high risk patients (ASA III group) require monitoring and care of an anesthesiologist.

endoscopy; conscious sedation; propofol; hemodynamic adverse effects

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