Sedation with propofol for routine ERCP in high-risk octogenarians: a randomized, controlled study.

Area of Science:

• Gastroenterology
• Anesthesiology
• Geriatric Medicine

Background:

• Sedation is crucial for endoscopic retrograde cholangiopancreatography (ERCP).
• Propofol, a short-acting anesthetic, has potential advantages for ERCP sedation.
• Limited data exists on propofol's safety and efficacy in elderly, high-risk patients.

Purpose of the Study:

• To evaluate the feasibility and safety of propofol sedation during ERCP in elderly, high-risk patients.
• To compare propofol monosegmentation with midazolam/meperidine in this patient population.

Main Methods:

• 150 patients aged 80+ years with high comorbidity (ASA score III+) were randomized.
• Group 1 (n=75) received midazolam plus meperidine; Group 2 (n=75) received propofol alone.
• Continuous monitoring of vital signs, recovery time, cooperation, and tolerance was performed.

Main Results:

• Propofol demonstrated significantly better patient cooperation (p < 0.01).
• Mean recovery time was significantly shorter with propofol (22 min vs. 31 min, p < 0.01).
• Fewer desaturation events (<90%) occurred during recovery in the propofol group (12% vs. 26%, p < 0.01).

Conclusions:

• Propofol sedation is superior to midazolam/meperidine for ERCP in high-risk octogenarians.
• Careful monitoring ensures the safe use of propofol in this demographic.
• Propofol offers improved recovery and cooperation with comparable vital sign stability.