Adequacy of Anesthesia Guidance for Colonoscopy Procedures
In patients undergoing colonoscopy procedures (CPs), inadequate dosing of hypnotic drugs (HD) and opioid analgesics (OA) during intravenous sedoanalgesia (ISA) may lead to intraprocedural awareness with recall (IAwR), intraprocedural (IPP) and postprocedural pain (PPP), as well as postoperative naus...
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| Format: | Article |
| Language: | English |
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MDPI AG
2021-05-01
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| Series: | Pharmaceuticals |
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| Online Access: | https://www.mdpi.com/1424-8247/14/5/464 |
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| author | Michał Jan Stasiowski Małgorzata Starzewska Ewa Niewiadomska Seweryn Król Kaja Marczak Jakub Żak Aleksandra Pluta Jerzy Eszyk Beniamin Oskar Grabarek Izabela Szumera Michał Nycz Anna Missir Lech Krawczyk Przemysław Jałowiecki |
| author_facet | Michał Jan Stasiowski Małgorzata Starzewska Ewa Niewiadomska Seweryn Król Kaja Marczak Jakub Żak Aleksandra Pluta Jerzy Eszyk Beniamin Oskar Grabarek Izabela Szumera Michał Nycz Anna Missir Lech Krawczyk Przemysław Jałowiecki |
| author_sort | Michał Jan Stasiowski |
| collection | DOAJ |
| description | In patients undergoing colonoscopy procedures (CPs), inadequate dosing of hypnotic drugs (HD) and opioid analgesics (OA) during intravenous sedoanalgesia (ISA) may lead to intraprocedural awareness with recall (IAwR), intraprocedural (IPP) and postprocedural pain (PPP), as well as postoperative nausea and vomiting (PONV). The aim of this study was to evaluate whether the titration of HD and OA based on the observance of changing values of state entropy (SE) and surgical pleth index (SPI) (adequacy of anesthesia—AoA), state entropy alone, or standard practice may reduce the number of adverse events. One hundred and fifty-eight patients were included in the final analysis. The rate of IAwR and IPP was statistically more frequent in patients from the C group in comparison with the AoA and SE groups (<i>p</i> < 0.01 and <i>p</i> < 0.05, respectively). In turn, the rate of PPP, PONV, and patients’ and operators’ satisfaction with ISA between groups was not statistically significant (<i>p</i> > 0.05). Changes in hemodynamic parameters, demand for HD, and OA were statistically significant, but of no clinical value. In patients undergoing CPs under ISA using propofol and FNT, as compared to standard practice, intraprocedural SE monitoring reduced the rate of IAwR and IPP, with no influence on the rate of PPP, PONV, or patients’ and endoscopists’ satisfaction. AoA guidance on propofol and FNT titration, as compared to SE monitoring only, did not reduce the occurrence of the aforementioned studied parameters, imposing an unnecessary extra cost. |
| first_indexed | 2024-03-10T11:24:04Z |
| format | Article |
| id | doaj.art-8dbeac3438ee4dae8e7f24ef228b8545 |
| institution | Directory Open Access Journal |
| issn | 1424-8247 |
| language | English |
| last_indexed | 2024-03-10T11:24:04Z |
| publishDate | 2021-05-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Pharmaceuticals |
| spelling | doaj.art-8dbeac3438ee4dae8e7f24ef228b85452023-11-21T19:47:33ZengMDPI AGPharmaceuticals1424-82472021-05-0114546410.3390/ph14050464Adequacy of Anesthesia Guidance for Colonoscopy ProceduresMichał Jan Stasiowski0Małgorzata Starzewska1Ewa Niewiadomska2Seweryn Król3Kaja Marczak4Jakub Żak5Aleksandra Pluta6Jerzy Eszyk7Beniamin Oskar Grabarek8Izabela Szumera9Michał Nycz10Anna Missir11Lech Krawczyk12Przemysław Jałowiecki13Department of Emergency Medicine, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 40-555 Katowice, PolandDepartment of Cardiac Anaesthesia and Intensive Care, Silesian Centre for Heart Diseases, 41-800 Zabrze, PolandDepartment of Epidemiology and Biostatistics, School Health Sciences in Bytom, Medical University of Silesia, Piekarska 18 Street, 41-902 Bytom, PolandDepartment of Anaesthesiology and Intensive Therapy, 5th Regional Hospital, Medykow Square 1, 41-200 Sosnowiec, PolandDepartment of Anaesthesiology and Intensive Therapy, 5th Regional Hospital, Medykow Square 1, 41-200 Sosnowiec, PolandDepartment of Emergency Medicine, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 40-555 Katowice, PolandDepartment of Emergency Medicine, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 40-555 Katowice, PolandUnit of Endoscopy by the Department of Gastroenterology, 5th Regional Hospital, Medykow Square 1, 41-200 Sosnowiec, PolandDepartment of Histology, Cytophysiology and Embryology, Faculty of Medicine in Zabrze, University of Technology in Katowice, 41-800 Zabrze, PolandDepartment of Emergency Medicine, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 40-555 Katowice, PolandDepartment of General, Colorectal and Polytrauma Surgery, Faculty of Health Sciences in Katowice, Medical University of Silesia, 40-555 Katowice, PolandDepartment of Anaesthesiology and Intensive Therapy, 5th Regional Hospital, Medykow Square 1, 41-200 Sosnowiec, PolandDepartment of Emergency Medicine, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 40-555 Katowice, PolandDepartment of Emergency Medicine, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 40-555 Katowice, PolandIn patients undergoing colonoscopy procedures (CPs), inadequate dosing of hypnotic drugs (HD) and opioid analgesics (OA) during intravenous sedoanalgesia (ISA) may lead to intraprocedural awareness with recall (IAwR), intraprocedural (IPP) and postprocedural pain (PPP), as well as postoperative nausea and vomiting (PONV). The aim of this study was to evaluate whether the titration of HD and OA based on the observance of changing values of state entropy (SE) and surgical pleth index (SPI) (adequacy of anesthesia—AoA), state entropy alone, or standard practice may reduce the number of adverse events. One hundred and fifty-eight patients were included in the final analysis. The rate of IAwR and IPP was statistically more frequent in patients from the C group in comparison with the AoA and SE groups (<i>p</i> < 0.01 and <i>p</i> < 0.05, respectively). In turn, the rate of PPP, PONV, and patients’ and operators’ satisfaction with ISA between groups was not statistically significant (<i>p</i> > 0.05). Changes in hemodynamic parameters, demand for HD, and OA were statistically significant, but of no clinical value. In patients undergoing CPs under ISA using propofol and FNT, as compared to standard practice, intraprocedural SE monitoring reduced the rate of IAwR and IPP, with no influence on the rate of PPP, PONV, or patients’ and endoscopists’ satisfaction. AoA guidance on propofol and FNT titration, as compared to SE monitoring only, did not reduce the occurrence of the aforementioned studied parameters, imposing an unnecessary extra cost.https://www.mdpi.com/1424-8247/14/5/464adequacy of anesthesia (AoA)state entropy (SE)response entropy (RE)surgical pleth index (SPI)colonoscopy procedure (CP)postoperative nausea and vomiting (PONV) |
| spellingShingle | Michał Jan Stasiowski Małgorzata Starzewska Ewa Niewiadomska Seweryn Król Kaja Marczak Jakub Żak Aleksandra Pluta Jerzy Eszyk Beniamin Oskar Grabarek Izabela Szumera Michał Nycz Anna Missir Lech Krawczyk Przemysław Jałowiecki Adequacy of Anesthesia Guidance for Colonoscopy Procedures Pharmaceuticals adequacy of anesthesia (AoA) state entropy (SE) response entropy (RE) surgical pleth index (SPI) colonoscopy procedure (CP) postoperative nausea and vomiting (PONV) |
| title | Adequacy of Anesthesia Guidance for Colonoscopy Procedures |
| title_full | Adequacy of Anesthesia Guidance for Colonoscopy Procedures |
| title_fullStr | Adequacy of Anesthesia Guidance for Colonoscopy Procedures |
| title_full_unstemmed | Adequacy of Anesthesia Guidance for Colonoscopy Procedures |
| title_short | Adequacy of Anesthesia Guidance for Colonoscopy Procedures |
| title_sort | adequacy of anesthesia guidance for colonoscopy procedures |
| topic | adequacy of anesthesia (AoA) state entropy (SE) response entropy (RE) surgical pleth index (SPI) colonoscopy procedure (CP) postoperative nausea and vomiting (PONV) |
| url | https://www.mdpi.com/1424-8247/14/5/464 |
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