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Target-Controlled Sedation with Propofol Infusion for PEG-J Placement in Advanced Parkinson's Disease: A Prospective
Janos Szederjesi1, Irina Săplăcan1, Alexandra Lazăr1
1Department of Intensive Care, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Târgu-Mureș, 540139 Târgu Mureș, Romania.
Introduction:
The management of sedation during percutaneous endoscopic gastrojejunostomy (PEG-J) placement in patients with advanced Parkinson's disease (PD) is challenging due to the complex interactions between PD treatment, anesthetic agents, and the disease's motor and non-motor symptoms. This study evaluates the effectiveness and safety of a target-controlled infusion (TCI) propofol protocol in the context of PEG-J placement in advanced PD patients.
Materials And Methods:
This prospective study included 169 patients diagnosed with advanced Parkinson's disease (Hoehn and Yahr stages 4 and 5) who underwent PEG-J placement at Târgu Mureș County Emergency Clinical Hospital, Romania. Sedation was induced and maintained using TCI propofol, with additional benzodiazepines and short-acting opioids, while muscle relaxants were not used. Procedural success rates and adverse outcomes were assessed for 30 days post-procedure.
Results:
The sedation protocol demonstrated a high procedural success rate. No deaths were reported within 30 days post-procedure.
Conclusion:
This study highlights the feasibility and clinical applicability of a TCI propofol protocol for PEG-J placement in patients with advanced PD (stages 4 and 5). While no deaths were recorded within the 30-day follow-up, the sample size is insufficient to draw definitive conclusions regarding long-term safety.
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