PMID- 32160946
OWN - NLM
STAT- MEDLINE
DCOM- 20210427
LR  - 20210427
IS  - 1097-6779 (Electronic)
IS  - 0016-5107 (Linking)
VI  - 92
IP  - 2
DP  - 2020 Aug
TI  - Propofol sedation with a target-controlled infusion pump in elderly patients 
      undergoing ERCP.
PG  - 301-307
LID - S0016-5107(20)30228-5 [pii]
LID - 10.1016/j.gie.2020.03.002 [doi]
AB  - BACKGROUND AND AIMS: Advanced age is an important risk factor for adverse events 
      (AEs) during propofol sedation for endoscopic procedures. This study aimed to 
      evaluate the safety and efficacy of nonanesthesiologist-administered propofol 
      (NAAP) sedation with a target-controlled infusion (TCI) system in elderly 
      patients during ERCP. METHODS: This study retrospectively analyzed 482 patients 
      who underwent ERCP under propofol sedation with a TCI system at Iwakuni Medical 
      Center between January 2014 and October 2016. Patients were divided into 3 groups 
      according to their age: group A, <70 years (n = 130); group B, >/=70 and <85 years 
      (n = 224); and group C, >/=85 years (n = 125). We compared the propofol dose and 
      AEs during ERCP. RESULTS: The median total infusion dose and minimum and maximum 
      target blood concentrations of propofol were 336 mg, 2.2 mug/mL, and 2.2 mug/mL in 
      group A; 184 mg, 1.0 mug/mL, and 1.4 mug/mL in group B; and 99 mg, .6 mug/mL, and 
      1.0 mug/mL in group C, respectively, with older groups requiring a lower dose (P < 
      .0001). Hypotension was observed in 23 patients (4.8%), with no significant 
      difference between groups (group A, 2.3%; group B, 6.3%; group C, 4.8%; P = .24). 
      Hypoxemia was observed in 16 patients (3.3%), with no significant difference 
      between groups (group A, 3.1%; group B, 4.9%; group C, .8%; P = .17). All AEs 
      were immediately resolved, and no procedures were aborted. CONCLUSIONS: NAAP 
      sedation with a TCI system during ERCP may be acceptable in elderly patients with 
      a lower dose of propofol than that used in younger patients.
CI  - Copyright (c) 2020 American Society for Gastrointestinal Endoscopy. Published by 
      Elsevier Inc. All rights reserved.
FAU - Ogawa, Taiji
AU  - Ogawa T
AD  - Department of Gastroenterology and Hepatology, Okayama University Graduate School 
      of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan.
FAU - Tomoda, Takeshi
AU  - Tomoda T
AD  - Department of Gastroenterology and Hepatology, Okayama University Graduate School 
      of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan.
FAU - Kato, Hironari
AU  - Kato H
AD  - Department of Gastroenterology and Hepatology, Okayama University Graduate School 
      of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan.
FAU - Akimoto, Yutaka
AU  - Akimoto Y
AD  - Department of Gastroenterology, Iwakuni Clinical Center, Iwakuni, Japan.
FAU - Tanaka, Shoichi
AU  - Tanaka S
AD  - Department of Gastroenterology, Iwakuni Clinical Center, Iwakuni, Japan.
FAU - Okada, Hiroyuki
AU  - Okada H
AD  - Department of Gastroenterology and Hepatology, Okayama University Graduate School 
      of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan.
LA  - eng
PT  - Journal Article
DEP - 20200308
PL  - United States
TA  - Gastrointest Endosc
JT  - Gastrointestinal endoscopy
JID - 0010505
RN  - 0 (Hypnotics and Sedatives)
RN  - YI7VU623SF (Propofol)
SB  - IM
CIN - Gastrointest Endosc. 2020 Aug;92(2):308-309. PMID: 32703365
CIN - Gastrointest Endosc. 2020 Aug;92(2):461-462. PMID: 32703380
MH  - Aged
MH  - Cholangiopancreatography, Endoscopic Retrograde
MH  - Conscious Sedation
MH  - Humans
MH  - Hypnotics and Sedatives/adverse effects
MH  - *Hypotension/chemically induced/epidemiology
MH  - Infusion Pumps
MH  - *Propofol/adverse effects
MH  - Retrospective Studies
EDAT- 2020/03/13 06:00
MHDA- 2021/04/28 06:00
CRDT- 2020/03/13 06:00
PHST- 2019/11/19 00:00 [received]
PHST- 2020/03/01 00:00 [accepted]
PHST- 2020/03/13 06:00 [pubmed]
PHST- 2021/04/28 06:00 [medline]
PHST- 2020/03/13 06:00 [entrez]
AID - S0016-5107(20)30228-5 [pii]
AID - 10.1016/j.gie.2020.03.002 [doi]
PST - ppublish
SO  - Gastrointest Endosc. 2020 Aug;92(2):301-307. doi: 10.1016/j.gie.2020.03.002. Epub 
      2020 Mar 8.