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Propofol-Based Sedation Versus General Anesthesia for Endoscopic Submucosal Dissection.

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General anesthesia improved dissection speed during gastric endoscopic submucosal dissection (ESD) compared to propofol sedation. General anesthesia also reduced adverse events like nausea and coughing, enhancing endoscopist performance.

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Area of Science:

  • Gastroenterology
  • Anesthesiology

Background:

  • Gastric endoscopic submucosal dissection (ESD) is an advanced endoscopic procedure.
  • Anesthetic management for ESD impacts procedure efficiency and patient safety.

Purpose of the Study:

  • To compare the efficacy and safety of general anesthesia versus propofol-based sedation for upper gastrointestinal ESD.
  • To evaluate the impact of anesthetic technique on dissection speed and adverse events.

Main Methods:

  • Retrospective analysis of 91 patients undergoing upper GI ESD between 2013-2015.
  • Patients were divided into two groups: propofol-based sedation (Group S, n=54) and general anesthesia (Group G, n=37).
  • Key outcomes included procedure time, lesion size, dissection speed, anesthesia time, and adverse events.

Main Results:

  • General anesthesia group (G) showed significantly higher dissection speed (36.02 mm/min) compared to the sedation group (S) (26.04 mm/min).
  • Group S experienced significantly higher incidences of nausea, coughing, oropharyngeal suctioning, and desaturation episodes (SpO2 < 90%).
  • No significant differences were observed in hemodynamic parameters, anesthesia time, or hospital stay between groups.

Conclusions:

  • General anesthesia enhances dissection speed and endoscopist performance in gastric ESD compared to propofol-based sedation.
  • General anesthesia may offer improved patient safety by reducing adverse events during ESD procedures.