Optimization of Deep Sedation with Spontaneous Respiration for Therapeutic Endoscopy Combining Propofol and Bispectral Index Monitoring
Background/Aims. This study aimed to establish optimal propofol anesthesia for therapeutic endoscopy, which has not been established. Methodology. We retrospectively investigated data on 89 patients who underwent upper-GI endoscopic submucosal dissection or endoscopic mucosal resection under anesthe...
| 主要な著者: | , , , , , , , , , , , |
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| フォーマット: | 論文 |
| 言語: | English |
| 出版事項: |
Hindawi Limited
2015-01-01
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| シリーズ: | Gastroenterology Research and Practice |
| オンライン･アクセス: | http://dx.doi.org/10.1155/2015/282149 |
| _version_ | 1827083021192265728 |
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| author | Kohei Matsumoto Akihito Nagahara Kenshi Matsumoto Yoichi Akazawa Hiroyuki Komori Yuta Nakagawa Tsutomu Takeda Hiroya Ueyama Yuji Shimada Daisuke Asaoka Mariko Hojo Sumio Watanabe |
| author_facet | Kohei Matsumoto Akihito Nagahara Kenshi Matsumoto Yoichi Akazawa Hiroyuki Komori Yuta Nakagawa Tsutomu Takeda Hiroya Ueyama Yuji Shimada Daisuke Asaoka Mariko Hojo Sumio Watanabe |
| author_sort | Kohei Matsumoto |
| collection | DOAJ |
| description | Background/Aims. This study aimed to establish optimal propofol anesthesia for therapeutic endoscopy, which has not been established. Methodology. We retrospectively investigated data on 89 patients who underwent upper-GI endoscopic submucosal dissection or endoscopic mucosal resection under anesthesia with propofol. Examined doses of propofol were changed according to efficacy and/or adverse events and classified into 5 periods. A bispectral index (BIS) monitor was used at Period 5 to decrease the incidence of adverse events caused by oversedation. The initial dose of propofol was administered after bolus injection of pethidine hydrochloride (0.5 mg/kg), and 1.0 mL of propofol was added every minute until the patients fell asleep. Continuous and bolus infusion were performed to maintain sedation. When the patient moved or an adverse event occurred, the maintenance dose examined was increased or decreased by 5 mL/h regardless of body weight. Results. Dose combinations (introduction : maintenance) and patient numbers for each period were as follows: Period 1 (n=27), 0.5 mg/kg : 5 mg/kg/h; Period 2 (n=11), 0.33 mg/kg : 3.3 mg/kg/h; Period 3 (n=7), 0.5 mg/kg : 3.3 mg/kg/h; Period 4 (n=14), 0.5 mg/kg : 2.5 mg/kg/h; Period 5 (n=30), 0.5 mg/kg : 2.5 mg/kg/h, using BIS monitor. During Period 5, an adverse event occurred in 10.0% of patients, which was lower than that for Periods 1–4. Conclusions. Period 5 propofol anesthesia with BIS protocol could be safe and useful for therapeutic endoscopy under deep sedation with spontaneous respiration. |
| first_indexed | 2025-03-20T03:42:31Z |
| format | Article |
| id | doaj.art-b51b41eb1a3f4751a9cfa5228a44a21f |
| institution | Directory Open Access Journal |
| issn | 1687-6121 1687-630X |
| language | English |
| last_indexed | 2025-03-20T03:42:31Z |
| publishDate | 2015-01-01 |
| publisher | Hindawi Limited |
| record_format | Article |
| series | Gastroenterology Research and Practice |
| spelling | doaj.art-b51b41eb1a3f4751a9cfa5228a44a21f2024-10-03T05:59:43ZengHindawi LimitedGastroenterology Research and Practice1687-61211687-630X2015-01-01201510.1155/2015/282149282149Optimization of Deep Sedation with Spontaneous Respiration for Therapeutic Endoscopy Combining Propofol and Bispectral Index MonitoringKohei Matsumoto0Akihito Nagahara1Kenshi Matsumoto2Yoichi Akazawa3Hiroyuki Komori4Yuta Nakagawa5Tsutomu Takeda6Hiroya Ueyama7Yuji Shimada8Daisuke Asaoka9Mariko Hojo10Sumio Watanabe11Department of Gastroenterology, Juntendo University School of Medicine, Tokyo 113-8421, JapanDepartment of Gastroenterology, Juntendo University School of Medicine, Tokyo 113-8421, JapanDepartment of Gastroenterology, Juntendo University School of Medicine, Tokyo 113-8421, JapanDepartment of Gastroenterology, Juntendo University School of Medicine, Tokyo 113-8421, JapanDepartment of Gastroenterology, Juntendo University School of Medicine, Tokyo 113-8421, JapanDepartment of Gastroenterology, Juntendo University School of Medicine, Tokyo 113-8421, JapanDepartment of Gastroenterology, Juntendo University School of Medicine, Tokyo 113-8421, JapanDepartment of Gastroenterology, Juntendo University School of Medicine, Tokyo 113-8421, JapanDepartment of Gastroenterology, Juntendo University School of Medicine, Tokyo 113-8421, JapanDepartment of Gastroenterology, Juntendo University School of Medicine, Tokyo 113-8421, JapanDepartment of Gastroenterology, Juntendo University School of Medicine, Tokyo 113-8421, JapanDepartment of Gastroenterology, Juntendo University School of Medicine, Tokyo 113-8421, JapanBackground/Aims. This study aimed to establish optimal propofol anesthesia for therapeutic endoscopy, which has not been established. Methodology. We retrospectively investigated data on 89 patients who underwent upper-GI endoscopic submucosal dissection or endoscopic mucosal resection under anesthesia with propofol. Examined doses of propofol were changed according to efficacy and/or adverse events and classified into 5 periods. A bispectral index (BIS) monitor was used at Period 5 to decrease the incidence of adverse events caused by oversedation. The initial dose of propofol was administered after bolus injection of pethidine hydrochloride (0.5 mg/kg), and 1.0 mL of propofol was added every minute until the patients fell asleep. Continuous and bolus infusion were performed to maintain sedation. When the patient moved or an adverse event occurred, the maintenance dose examined was increased or decreased by 5 mL/h regardless of body weight. Results. Dose combinations (introduction : maintenance) and patient numbers for each period were as follows: Period 1 (n=27), 0.5 mg/kg : 5 mg/kg/h; Period 2 (n=11), 0.33 mg/kg : 3.3 mg/kg/h; Period 3 (n=7), 0.5 mg/kg : 3.3 mg/kg/h; Period 4 (n=14), 0.5 mg/kg : 2.5 mg/kg/h; Period 5 (n=30), 0.5 mg/kg : 2.5 mg/kg/h, using BIS monitor. During Period 5, an adverse event occurred in 10.0% of patients, which was lower than that for Periods 1–4. Conclusions. Period 5 propofol anesthesia with BIS protocol could be safe and useful for therapeutic endoscopy under deep sedation with spontaneous respiration.http://dx.doi.org/10.1155/2015/282149 |
| spellingShingle | Kohei Matsumoto Akihito Nagahara Kenshi Matsumoto Yoichi Akazawa Hiroyuki Komori Yuta Nakagawa Tsutomu Takeda Hiroya Ueyama Yuji Shimada Daisuke Asaoka Mariko Hojo Sumio Watanabe Optimization of Deep Sedation with Spontaneous Respiration for Therapeutic Endoscopy Combining Propofol and Bispectral Index Monitoring Gastroenterology Research and Practice |
| title | Optimization of Deep Sedation with Spontaneous Respiration for Therapeutic Endoscopy Combining Propofol and Bispectral Index Monitoring |
| title_full | Optimization of Deep Sedation with Spontaneous Respiration for Therapeutic Endoscopy Combining Propofol and Bispectral Index Monitoring |
| title_fullStr | Optimization of Deep Sedation with Spontaneous Respiration for Therapeutic Endoscopy Combining Propofol and Bispectral Index Monitoring |
| title_full_unstemmed | Optimization of Deep Sedation with Spontaneous Respiration for Therapeutic Endoscopy Combining Propofol and Bispectral Index Monitoring |
| title_short | Optimization of Deep Sedation with Spontaneous Respiration for Therapeutic Endoscopy Combining Propofol and Bispectral Index Monitoring |
| title_sort | optimization of deep sedation with spontaneous respiration for therapeutic endoscopy combining propofol and bispectral index monitoring |
| url | http://dx.doi.org/10.1155/2015/282149 |
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