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Published on: December 6, 2016
Sedation with propofol for interventional endoscopy by trained nurses in high-risk octogenarians: a prospective,
D Schilling1, A Rosenbaum, S Schweizer
1Department of Gastroenterology and Interventional Endoscopy, Diakonie Hospital Mannheim, Germany. D.schilling@diako-ma.de
Endoscopy
|April 3, 2009
Summary
Nurse-administered propofol sedation (NAPS) is safe for elderly, high-risk patients undergoing interventional endoscopy. This sedation method proved as effective as midazolam/pethidine, with better patient cooperation and faster recovery.
Area of Science:
- Anesthesiology
- Gastroenterology
- Geriatric Medicine
Background:
- Propofol offers advantages for sedation in interventional endoscopy.
- Limited data exists on nurse-administered propofol sedation (NAPS) safety in elderly, high-risk patients.
Purpose of the Study:
- To evaluate the safety and efficacy of NAPS compared to midazolam/pethidine in high-risk elderly patients undergoing interventional endoscopy.
Main Methods:
- 150 patients over 80 years old with high comorbidity were randomized to NAPS or midazolam/pethidine.
- Sedation was supervised by a dedicated nurse and physician.
- Procedures included ERCP, EUS, and DBE; 30-day mortality and morbidity were analyzed.
Main Results:
- Cardiopulmonary complication rates were similar between groups (16% vs. 23.7%, P > 0.05).
- Propofol showed greater, yet acceptable, declines in oxygen saturation and blood pressure.
- Patient cooperation was significantly better with propofol, and recovery oxygen saturation was also improved.
Conclusions:
- Nurse-administered propofol sedation is a safe alternative to midazolam/pethidine for high-risk elderly patients during interventional endoscopy.
- NAPS demonstrates comparable safety and improved patient cooperation and recovery characteristics.
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