Navigation Links
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 who would be at the highest risk for needing AMs.

"Future studies are likely to identify additional clinical predictors, which may impact the choice of sedatives and level of airway training required to safely administer propofol," added Dr. Jonnalagadda. "While propofol is undoubtedly an attractive sedative for endoscopic procedures, there continues to be debate regarding its safe use by non-anesthesiologists. Newer technologies such as computer-assisted personalized sedation are likely to standardize the use of propofol by non-anesthesiologists in endoscopy."

Propofol is an effective sedative in advanced endoscopy. However, the incidence of sedation-related complications is unclear. Initially approved for the induction and maintenance of anesthesia, propofol has become an increasingly popular sedative for endoscopic procedures due to its rapid onset of action (30 to 45 seconds) and short duration of effect.

The AGA Institute believes that the administration of propofol by non-anesthesiologists is safe and that proper training and patient selection are crucial, as outlined in the "Position Statement: Non-Anesthesiologist Administration of Propofol for GI Endoscopy" issued by the four major gastroenterology and hepatology societies and published in the December 2009 issue of Gastroenterology.


'/>"/>

Contact: Alissa J. Cruz
media@gastro.org
301-272-1603
American Gastroenterological Association
Source:Eurekalert

Related medicine news :

1. Quantros Licenses Adverse Event Identification Technology from University of Michigan
2. News brief: Adverse symptom reporting by patients vs. clinicians
3. Morpace Reports: H1N1 Flu Could Adversely Impact Holiday Shopping Season
4. Social Isolation Adversely Affects Breast Cancer
5. Cogent trial shows lack of adverse interaction between clopidogrel and stomach medicine
6. Headache Publication Describes Potential Mechanistic Rationale for LEVADEX(TM) Favorable Adverse Event Profile
7. Despite ongoing safety concerns, study finds adverse reactions from contrast agents rarely occur
8. National Poll Finds Most Americans Believe Immigration Adversely Affects the Quality and Cost of Healthcare
9. Study finds adverse effects in treatment for primary sclerosing cholangitis
10. Reglan Adverse Events More Than Doubled from 2006 to 2008
11. Abbotts XIENCE V(R) Demonstrates Impressive Low Rates of Repeat Procedure, Stent Thrombosis and Major Adverse Cardiac Events in Complex, Real World Patients in SPIRIT V Study
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:6/24/2016)... ... June 24, 2016 , ... Global law firm Greenberg Traurig, P.A. ... The attorneys chosen by their peers for this recognition are considered among the top ... Shareholders received special honors as members of this year’s Legal Elite Hall of Fame: ...
(Date:6/24/2016)... Diego, CA (PRWEB) , ... June 24, 2016 , ... ... with the American Cancer Society and the Road To Recovery® program to drive cancer ... to seniors and other adults to ensure the highest quality of life and ongoing ...
(Date:6/24/2016)... ... 24, 2016 , ... People across the U.S. are sharpening their pencils and ... essay contest in which patients and their families pay tribute to a genetic counselor ... National Society of Genetic Counselors (NSGC) Annual Education Conference (AEC) this September. , ...
(Date:6/24/2016)... , ... June 24, 2016 , ... ... is proud to recognize Dr. Barry M. Weintraub as a prominent plastic surgeon ... beautiful women in the world, and the most handsome men, look naturally attractive. ...
(Date:6/24/2016)... Maryland (PRWEB) , ... June 24, 2016 , ... ... Angels is actively feeding the Frederick area economy by obtaining investment capital for ... over the past 2½ years that have already resulted in more than a ...
Breaking Medicine News(10 mins):
(Date:6/24/2016)...   Pulmatrix, Inc ., (NASDAQ: PULM ... announced today that it was added to the Russell ... comprehensive set of U.S. and global equity indexes on ... milestone for Pulmatrix," said Chief Executive Officer Robert ... progress in developing drugs for crucial unmet medical needs, ...
(Date:6/23/2016)... Research and Markets has announced the addition of ... report to their offering. ... kidney failure, it replaces the function of kidneys by removing ... thus the treatment helps to keep the patient body,s electrolytes ... Increasing number of ESRD patients & substantial healthcare expenditure ...
(Date:6/23/2016)... , June 23, 2016 Roche (SIX: ... 510(k) clearance for its Elecsys BRAHMS PCT (procalcitonin) assay ... sepsis or septic shock. With this clearance, Roche is ... a fully integrated solution for sepsis risk assessment and ... with bacterial infection and PCT levels in blood can ...
Breaking Medicine Technology: