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:2/8/2016)... ... February 08, 2016 , ... If you are feeling that your clothes are ... alone. According to the Center for Disease Control and Prevention (CDC), 34.9% of U.S. ... certain types of cancer, some of the leading causes of preventable death. February ...
(Date:2/8/2016)... ... 08, 2016 , ... Delta Dental of California and its affiliated companies announced ... D. Radine, who recently retired as president and CEO of Delta Dental of California ... of the Year , helped lead the effort to raise funds for studies to ...
(Date:2/8/2016)... ... 08, 2016 , ... Discover the Rocky Mountain region’s longest running and impressive ... Attendees also get to see the most incredible gardens and home improvement experts ... at the Colorado Convention Center - 700 14th St. Denver CO, is an exciting ...
(Date:2/8/2016)... (PRWEB) , ... February 08, 2016 , ... Guruji Mahendra ... 9th, 10th and 11th, 2016 in honor of his birthday on February 10th. ... happiness. Mahendra Trivedi is known by over 250,000 people from over 40 different ...
(Date:2/7/2016)... ... February 07, 2016 , ... ... MyDecision™ empowers employers and organizations with the tools and information to lower the ... elements to cut the cost of providing employee healthcare benefits by as much ...
Breaking Medicine News(10 mins):
(Date:2/5/2016)... DUBLIN , Feb. 5, 2016 /PRNewswire/ ... announced the addition of the "Global ... financials" company profile to their offering. ... announced the addition of the "Global ... financials" company profile to their offering. ...
(Date:2/5/2016)... BEIJING , Feb. 5, 2016 ... ("Dehaier Medical" or the "Company"), which develops, markets ... products in China and ... restructuring plan which aims to concentrate the Company,s ... wearable sleep respiratory business and to focus more ...
(Date:2/5/2016)... 2016 Site Profile: --> ... - The Speech Recognition People, announced their latest primary healthcare case ... care, reduce turnaround times and to save the practice money. ... since 2013 Challenge: --> ,- Wirral CCG ... - Six doctors ,- Wirral CCG ,- VoicePower client since 2013 ...
Breaking Medicine Technology: