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Sedation in gastrointestinal endoscopy: Where are we at in 2014? 被引量:8

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摘要 Gastrointestinal endoscopies are invasive and unpleasant procedures that are increasingly being used worldwide. The importance of high quality procedures(especially in colorectal cancer screening), the increasing patient awareness and the expectation of painless examination, increase the need for procedural sedation. The best single sedation agent for endoscopy is propofol which, due to its' pharmacokinetic/dynamic profile allows for a higher patient satisfaction and procedural quality and lower induction and recovery times, while ma-intaining the safety of traditional sedation. Propofol is an anesthetic agent when used in higher doses than those needed for endoscopy. Because of this important feature it may lead to cardiovascular and respiratory depression and, ultimately, to cardiac arrest and death. Fueled by this argument, concern over the safety of its administration by personnel without general anesthesia training has arisen. Propofol usage seems to be increasing but it's still underused. It is a safe alternative for simple endoscopic procedures in low risk patients even if administered by non-anesthesiologists. Evidence on propofol safety in complex procedures and high risk patients is less robust and in these cases, the presence of an anesthetist should be considered. We review the existing evidence on the topic and evaluate the regional differences on sedation practices. Gastrointestinal endoscopies are invasive and unpleasantprocedures that are increasingly being used worldwide.The importance of high quality procedures (especiallyin colorectal cancer screening), the increasing patientawareness and the expectation of painless examination,increase the need for procedural sedation. The bestsingle sedation agent for endoscopy is propofol which,due to its' pharmacokinetic/dynamic profile allows fora higher patient satisfaction and procedural qualityand lower induction and recovery times, while ma-maintaining
出处 《World Journal of Gastrointestinal Endoscopy》 2015年第2期102-109,共8页 世界胃肠内镜杂志(英文版)(电子版)
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  • 1Wang D, Chen C, Chen J, Xu Y, Wang L, Zhu Z, Deng D, ChenJ, Long A, Tang D, Liu J. The use of propofol as a sedative agentin gastrointestinal endoscopy: a meta-analysis. PLoS One 2013; 8:e53311 [PMID: 23308191 DOI: 10.1371/journal.pone.0053311].
  • 2Singh H, Poluha W, Cheung M, Choptain N, Baron KI, TabackSP. Propofol for sedation during colonoscopy. CochraneDatabase Syst Rev 2008; (4): CD006268 [PMID: 18843709 DOI:10.1002/14651858.CD006268.pub2].
  • 3Bannert C, Reinhart K, Dunkler D, Trauner M, Renner F, KnoflachP, Ferlitsch A, Weiss W, Ferlitsch M. Sedation in screeningcolonoscopy: impact on quality indicators and complications. AmJ Gastroenterol 2012; 107: 1837-1848 [PMID: 23147522 DOI:10.1038/ajg.2012.347].
  • 4Reves JG, Fragen RJ, Vinik HR, Greenblatt DJ. Midazolam:pharmacology and uses. Anesthesiology 1985; 62: 310-324 [PMID:3156545].
  • 5Kanto JH. Midazolam: the first water-soluble benzodiazepine.Pharmacology, pharmacokinetics and efficacy in insomnia andanesthesia. Pharmacotherapy 1985; 5: 138-155 [PMID: 3161005].
  • 6Cole SG, Brozinsky S, Isenberg JI. Midazolam, a new more potentbenzodiazepine, compared with diazepam: a randomized, doubleblindstudy of preendoscopic sedatives. Gastrointest Endosc 1983;29: 219-222 [PMID: 6618119].
  • 7Cohen LB, Delegge MH, Aisenberg J, Brill JV, Inadomi JM,Kochman ML, Piorkowski JD. AGA Institute review of endoscopicsedation. Gastroenterology 2007; 133: 675-701 [PMID: 17681185DOI: 10.1053/j.gastro.2007.06.002].
  • 8Patel S, Vargo JJ, Khandwala F, Lopez R, Trolli P, DumotJA, Conwell DL, Zuccaro G. Deep sedation occurs frequentlyduring elective endoscopy with meperidine and midazolam. AmJ Gastroenterol 2005; 100: 2689-2695 [PMID: 16393221 DOI:10.1111/j.1572-0241.2005.00320.x].
  • 9Tae CH, Kang KJ, Min BH, Ahn JH, Kim S, Lee JH, Rhee PL,Kim JJ. Paradoxical reaction to midazolam in patients undergoingendoscopy under sedation: Incidence, risk factors and the effect offlumazenil. Dig Liver Dis 2014; 46: 710-715 [PMID: 24893689DOI: 10.1016/j.dld.2014.04.007].
  • 10Hara M, Kai Y, Ikemoto Y. Propofol activates GABAA receptorchlorideionophore complex in dissociated hippocampal pyramidalneurons of the rat. Anesthesiology 1993; 79: 781-788 [PMID:8214758].

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