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Adverse events rate is low when propofol is administered by trained professional
Date:3/3/2010

Propofol is safe for advanced endoscopic procedures with a low rate of sedation-related adverse events when administered by a trained professional, according to a new study in Clinical Gastroenterology and Hepatology, the official journal of the American Gastroenterological Association (AGA) Institute.

"This is the first paper to report the frequency of airway modifications (AMs) associated with propofol use in endoscopy. We believe that the need to perform AMs highlights the importance of a trained professional, such as a nurse anesthetist, who is solely responsible for maintenance of sedation and patient monitoring while using propofol," said Sreenivasa S. Jonnalagadda, MD, of the Washington University School of Medicine and lead author of the study. "Perhaps the highest-risk patients should be managed by nurse anesthetists trained in advanced airway interventions, whereas lower-risk patients can be safely managed by professionals with less intensive airway training."

Doctors prospectively studied patients undergoing sedation with propofol for advanced endoscopic procedures, including endoscopic retrograde cholangiopancreatography, endoscopic ultrasound and small bowel enteroscopy; a total of 799 patients were enrolled over seven months. Sedative dosing was determined by a certified registered nurse anesthetist with a goal of achieving deep sedation. Sedation-related complications included 154 AMs performed in 115 patients, such as 97 chin lifts, 29 modified face mask ventilations and 28 nasal airways. Additional complications included hypoxemia (deficient oxygenation of the blood, 12.8 percent); hypotension requiring vaso-pressors (abnormally low blood pressure, 0.5 percent); and early procedure termination (0.6 percent); these rates are comparable to other published data.

Elevated BMI, male sex and American Society of Anesthesiologist class greater than or equal to three were found to be independent predictors of patients
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Contact: Alissa J. Cruz
media@gastro.org
301-272-1603
American Gastroenterological Association
Source:Eurekalert

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