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Endoscopic Procedures I: Esophagogastroduodenoscopy01:29

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External Cephalic Version: Is it an Effective and Safe Procedure?
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Computer-Assisted Propofol Sedation for Esophagogastroduodenoscopy Is Effective, Efficient, and Safe.

Otto S Lin1, Danielle La Selva2, Richard A Kozarek2

  • 1Digestive Disease Institute, Virginia Mason Medical Center, 1100 Ninth Avenue, Seattle, WA, 98101, USA. Otto.Lin@vmmc.org.

Digestive Diseases and Sciences
|June 6, 2019
PubMed
Summary

Computer-assisted propofol sedation (CAPS) offers a safe and effective method for gastrointestinal procedures. This sedation technique significantly reduces patient recovery times compared to traditional methods.

Keywords:
EsophagogastroduodenoscopyPropofolSafetySedation

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Area of Science:

  • Gastroenterology
  • Sedation Medicine
  • Medical Technology

Background:

  • Computer-assisted propofol sedation (CAPS) enables non-anesthesiologists to administer propofol for gastrointestinal procedures.
  • This study reports the first US medical center's 1-year experience implementing CAPS for routine esophagogastroduodenoscopy (EGD).

Purpose of the Study:

  • To evaluate the safety, efficacy, and efficiency of CAPS for EGD procedures.
  • To compare CAPS outcomes with historical data from midazolam and fentanyl sedation.

Main Methods:

  • A retrospective analysis of 926 outpatient EGDs performed with CAPS between September 2014 and August 2015.
  • Comparison of procedural success rates, procedure times, and recovery times against historical controls (September 2013 - August 2014).
  • Recording and analysis of adverse events in the CAPS cohort.

Main Results:

  • Procedural success rates were similar between CAPS and historical controls (99.0% vs. 99.3%).
  • Procedure times were comparable (6.6 min vs. 7.4 min).
  • Recovery time was significantly shorter with CAPS (31.7 min vs. 52.4 min; p < 0.001).
  • Adverse events included mild oxygen desaturation (1.2%), agitation (1.6%), and one case of asymptomatic hypotension. Six patients required brief mask ventilation for desaturation.

Conclusions:

  • Computer-assisted propofol sedation (CAPS) is a safe, effective, and efficient sedation method for EGD in healthy patients.
  • CAPS demonstrates a significant reduction in patient recovery time compared to traditional sedation methods.