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New GI technologies improve internal organ visualization

rlottesville Medical Research in Virginia, have continued this trend to monitor and deliver sedation during surgery with computer assisted personalized sedation (CAPS), which uses computer software to facilitate precise control of drug delivery.

Anesthesiologists and physician/nurse care teams in the study first injected 24 patients (12 colonoscopy and 12 endoscopy) with a single dose of fentanyl as pre-medication, then administered propofol using the CAPS system and its dosing algorithm and safety shell--a control safeguard software program. Data was downloaded from the sedation device to a laptop computer to measure patient response throughout the procedure and adjust the sedation dosage accordingly. Patient responsiveness was monitored by the anesthesiologist using the Modified Observer's Assessment of Alertness/Sedation (MOAA/S) scale and the Automated Responsiveness Monitor (ARM) device. The MOAA scale assesses the patient's level of sedation from alert to only responding to a painful stimulus, and the ARM is a handheld device that the patient squeezes on command from a voice from an earpiece in the patient's ear. This response helps determine the level of sedation.

All procedures were completed successfully and six patients had at least one polyp removed. Of the 24 patients, 14 (7 colonoscopy and 7 endoscopy) lost responsiveness to ARM during the procedure. One subject experienced oxygen desaturation (level of breathing and sedation) below 90 percent (low=85 percent) and seven subjects experienced apnea for less than 30 seconds. However, the device automatically responded to these adverse physiological reactions by adjusting sedation amounts and all eight subjects recovered to normal respiratory parameters without intervention by the anesthesiologist.

"This new technology represents an exciting breakthrough in the use of computers to properly administer and monitor sedation in patients undergoing a variety of procedures," sai
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Source:American Gastroenterological Association


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