A target-controlled infusion system with bispectral index monitoring of propofol sedation during endoscopic submucosal dissection
Background and study aims: Propofol administration via a target-controlled infusion system with bispectral index monitoring (BIS/TCI system) is expected to prevent complications from sedation during complex and long endoscopic procedures. We evaluated the feasibility of setting the BIS/TCI system fo...
| Main Authors: | , , , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Georg Thieme Verlag KG
2015-02-01
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| Series: | Endoscopy International Open |
| Online Access: | http://www.thieme-connect.de/DOI/DOI?10.1055/s-0034-1377519 |
| _version_ | 1828348074516283392 |
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| author | Atsushi Imagawa Hidenori Hata Morihito Nakatsu Akihiro Matsumi Eijiro Ueta Kozue Suto Hiroyuki Terasawa Hiroyuki Sakae Keiko Takeuchi Manabu Fujihara Hitomi Endo Hisae Yasuhara Shinichi Ishihara Hiromitsu Kanzaki Hideki Jinno Hidenori Kamada Eisuke Kaji Akio Moriya Masaharu Ando |
| author_facet | Atsushi Imagawa Hidenori Hata Morihito Nakatsu Akihiro Matsumi Eijiro Ueta Kozue Suto Hiroyuki Terasawa Hiroyuki Sakae Keiko Takeuchi Manabu Fujihara Hitomi Endo Hisae Yasuhara Shinichi Ishihara Hiromitsu Kanzaki Hideki Jinno Hidenori Kamada Eisuke Kaji Akio Moriya Masaharu Ando |
| author_sort | Atsushi Imagawa |
| collection | DOAJ |
| description | Background and study aims: Propofol administration via a target-controlled infusion system with bispectral index monitoring (BIS/TCI system) is expected to prevent complications from sedation during complex and long endoscopic procedures. We evaluated the feasibility of setting the BIS/TCI system for non-anesthesiologist administration of propofol (NAAP) during endoscopic submucosal dissection (ESD).
Patients and methods: From May 2009 to February 2013, 250 patients with esophagogastric neoplasms were treated with ESD using the BIS/TCI system with NAAP. In the TCI system, the initial target blood concentration of propofol was set at 1.2 μg/mL. The titration speed of propofol was adjusted according to the BIS score and the movement of the patient. The BIS target level ranged from moderate to deep sedation, at which a stable BIS score between 60 and 80 was obtained.
Results: In 80.4 % of patients, it was possible to maintain stable sedation with a blood concentration of propofol of less than 1.6 µg/mL using TCI throughout the ESD procedure. The default setting for ideal blood concentration of propofol was 1.2 μg/mL, because the medians of the lower and upper bounds of blood concentration were 1.2 μg/mL (range 0.6 – 1.8 μg/mL) and 1.4 μg/mL (range 1.0 – 3.8 μg/mL), respectively. Although hypotension occurred in 27 patients (10.8 %), oxygen desaturation occurred in only nine patients (3.6 %), and severe desaturation in only two patients (0.8 %).
Conclusions: Using our settings, it is possible for a non-anesthesiologist to maintain stable sedation during a lengthy endoscopic procedure through propofol sedation with a BIS/TCI system. |
| first_indexed | 2024-04-14T00:49:46Z |
| format | Article |
| id | doaj.art-6b1b678e97c3439bb083095cba3a697e |
| institution | Directory Open Access Journal |
| issn | 2364-3722 2196-9736 |
| language | English |
| last_indexed | 2024-04-14T00:49:46Z |
| publishDate | 2015-02-01 |
| publisher | Georg Thieme Verlag KG |
| record_format | Article |
| series | Endoscopy International Open |
| spelling | doaj.art-6b1b678e97c3439bb083095cba3a697e2022-12-22T02:21:51ZengGeorg Thieme Verlag KGEndoscopy International Open2364-37222196-97362015-02-010301E2E610.1055/s-0034-1377519A target-controlled infusion system with bispectral index monitoring of propofol sedation during endoscopic submucosal dissectionAtsushi Imagawa0Hidenori Hata1Morihito Nakatsu2Akihiro Matsumi3Eijiro Ueta4Kozue Suto5Hiroyuki Terasawa6Hiroyuki Sakae7Keiko Takeuchi8Manabu Fujihara9Hitomi Endo10Hisae Yasuhara11Shinichi Ishihara12Hiromitsu Kanzaki13Hideki Jinno14Hidenori Kamada15Eisuke Kaji16Akio Moriya17Masaharu Ando18Department of Gastroenterology, Mitoyo General Hospital, Kagawa, JapanDepartment of Gastroenterology, Mitoyo General Hospital, Kagawa, JapanDepartment of Gastroenterology, Mitoyo General Hospital, Kagawa, JapanDepartment of Gastroenterology, Mitoyo General Hospital, Kagawa, JapanDepartment of Gastroenterology, Mitoyo General Hospital, Kagawa, JapanDepartment of Gastroenterology, Mitoyo General Hospital, Kagawa, JapanDepartment of Gastroenterology, Mitoyo General Hospital, Kagawa, JapanDepartment of Gastroenterology, Mitoyo General Hospital, Kagawa, JapanDepartment of Gastroenterology, Mitoyo General Hospital, Kagawa, JapanDepartment of Gastroenterology, Mitoyo General Hospital, Kagawa, JapanDepartment of Gastroenterology, Mitoyo General Hospital, Kagawa, JapanDepartment of Gastroenterology, Mitoyo General Hospital, Kagawa, JapanDepartment of Gastroenterology, Mitoyo General Hospital, Kagawa, JapanDepartment of Gastroenterology, Mitoyo General Hospital, Kagawa, JapanDepartment of Gastroenterology, Mitoyo General Hospital, Kagawa, JapanDepartment of Gastroenterology, Mitoyo General Hospital, Kagawa, JapanDepartment of Gastroenterology, Mitoyo General Hospital, Kagawa, JapanDepartment of Gastroenterology, Mitoyo General Hospital, Kagawa, JapanDepartment of Gastroenterology, Mitoyo General Hospital, Kagawa, JapanBackground and study aims: Propofol administration via a target-controlled infusion system with bispectral index monitoring (BIS/TCI system) is expected to prevent complications from sedation during complex and long endoscopic procedures. We evaluated the feasibility of setting the BIS/TCI system for non-anesthesiologist administration of propofol (NAAP) during endoscopic submucosal dissection (ESD). Patients and methods: From May 2009 to February 2013, 250 patients with esophagogastric neoplasms were treated with ESD using the BIS/TCI system with NAAP. In the TCI system, the initial target blood concentration of propofol was set at 1.2 μg/mL. The titration speed of propofol was adjusted according to the BIS score and the movement of the patient. The BIS target level ranged from moderate to deep sedation, at which a stable BIS score between 60 and 80 was obtained. Results: In 80.4 % of patients, it was possible to maintain stable sedation with a blood concentration of propofol of less than 1.6 µg/mL using TCI throughout the ESD procedure. The default setting for ideal blood concentration of propofol was 1.2 μg/mL, because the medians of the lower and upper bounds of blood concentration were 1.2 μg/mL (range 0.6 – 1.8 μg/mL) and 1.4 μg/mL (range 1.0 – 3.8 μg/mL), respectively. Although hypotension occurred in 27 patients (10.8 %), oxygen desaturation occurred in only nine patients (3.6 %), and severe desaturation in only two patients (0.8 %). Conclusions: Using our settings, it is possible for a non-anesthesiologist to maintain stable sedation during a lengthy endoscopic procedure through propofol sedation with a BIS/TCI system.http://www.thieme-connect.de/DOI/DOI?10.1055/s-0034-1377519 |
| spellingShingle | Atsushi Imagawa Hidenori Hata Morihito Nakatsu Akihiro Matsumi Eijiro Ueta Kozue Suto Hiroyuki Terasawa Hiroyuki Sakae Keiko Takeuchi Manabu Fujihara Hitomi Endo Hisae Yasuhara Shinichi Ishihara Hiromitsu Kanzaki Hideki Jinno Hidenori Kamada Eisuke Kaji Akio Moriya Masaharu Ando A target-controlled infusion system with bispectral index monitoring of propofol sedation during endoscopic submucosal dissection Endoscopy International Open |
| title | A target-controlled infusion system with bispectral index monitoring of propofol sedation during endoscopic submucosal dissection |
| title_full | A target-controlled infusion system with bispectral index monitoring of propofol sedation during endoscopic submucosal dissection |
| title_fullStr | A target-controlled infusion system with bispectral index monitoring of propofol sedation during endoscopic submucosal dissection |
| title_full_unstemmed | A target-controlled infusion system with bispectral index monitoring of propofol sedation during endoscopic submucosal dissection |
| title_short | A target-controlled infusion system with bispectral index monitoring of propofol sedation during endoscopic submucosal dissection |
| title_sort | target controlled infusion system with bispectral index monitoring of propofol sedation during endoscopic submucosal dissection |
| url | http://www.thieme-connect.de/DOI/DOI?10.1055/s-0034-1377519 |
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