PMID- 36793626
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20230217
IS  - 2307-8960 (Print)
IS  - 2307-8960 (Electronic)
IS  - 2307-8960 (Linking)
VI  - 11
IP  - 3
DP  - 2023 Jan 26
TI  - Efficacy and safety of propofol target-controlled infusion combined with 
      butorphanol for sedated colonoscopy.
PG  - 610-620
LID - 10.12998/wjcc.v11.i3.610 [doi]
AB  - BACKGROUND: Propofol is a short-acting, rapid-recovering anesthetic widely used 
      in sedated colonoscopy for the early detection, diagnosis and treatment of colon 
      diseases. However, the use of propofol alone may require high doses to achieve 
      the induction of anesthesia in sedated colonoscopy, which has been associated 
      with anesthesia-related adverse events (AEs), including hypoxemia, sinus 
      bradycardia, and hypotension. Therefore, propofol co-administrated with other 
      anesthetics has been proposed to reduce the required dose of propofol, enhance 
      the efficacy, and improve the satisfaction of patients receiving colonoscopy 
      under sedation. AIM: To evaluate the efficacy and safety of propofol 
      target-controlled infusion (TCI) in combination with butorphanol for sedation 
      during colonoscopy. METHODS: In this controlled clinical trial, a total of 106 
      patients, who were scheduled for sedated colonoscopy, were prospectively 
      recruited and assigned into three groups to receive different doses of 
      butorphanol before propofol TCI: Low-dose butorphanol group (5 mug/kg, group B1), 
      high-dose butorphanol group (10 mug/kg, group B2), and control group (normal 
      saline, group C). Anesthesia was achieved by propofol TCI. The primary outcome 
      was the median effective concentration (EC50) of propofol TCI, which was measured 
      using the up-and-down sequential method. The secondary outcomes included AEs in 
      perianesthesia and recovery characteristics. RESULTS: The EC50 of propofol for 
      TCI was 3.03 mug/mL [95% confidence interval (CI): 2.83-3.23 mug/mL] in group B2, 
      3.41 mug/mL (95%CI: 3.20-3.62 mug/mL) in group B1, and 4.05 mug/mL (95%CI: 3.78-4.34 
      mug/mL) in group C. The amount of propofol necessary for anesthesia was 132 mg 
      [interquartile range (IQR), 125-144.75 mg] in group B2 and 142 mg (IQR, 135-154 
      mg) in group B1. Furthermore, the awakening concentration was 1.1 mug/mL (IQR, 
      0.9-1.2 mug/mL) in group B2 and 1.2 mug/mL (IQR, 1.025-1.5 mug/mL) in group B1. 
      Notably, the propofol TCI plus butorphanol groups (groups B1 and B2) had a lower 
      incidence of anesthesia AEs, when compared to group C. Furthermore, no 
      significant differences were observed in the rates of AEs in perianesthesia, 
      including hypoxemia, sinus bradycardia, hypotension, nausea and vomiting, and 
      vertigo, among group C, group B1 and group B2. CONCLUSION: The combined use with 
      butorphanol reduces the EC50 of propofol TCI for anesthesia. The decrease in 
      propofol might contribute to the reduced anesthesia-related AEs in patients 
      undergoing sedated colonoscopy.
CI  - (c)The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights 
      reserved.
FAU - Guo, Feng
AU  - Guo F
AD  - Department of Anesthesiology, No. 967 Hospital, Joint Logistics Support Force of 
      Chinese People's Liberation Army, Dalian 116011, Liaoning Province, China.
FAU - Sun, De-Feng
AU  - Sun DF
AD  - Department of Anesthesiology, The First Affiliated Hospital of Dalian Medical 
      University, Dalian 116011, Liaoning Province, China. sundefengyl@163.com.
FAU - Feng, Yan
AU  - Feng Y
AD  - Department of Anesthesiology, The First Affiliated Hospital of Dalian Medical 
      University, Dalian 116011, Liaoning Province, China.
FAU - Yang, Lin
AU  - Yang L
AD  - Department of Neuroelectrophysiology, The First Affiliated Hospital of Dalian 
      Medical University, Dalian 11601, Liaoning Province, China.
FAU - Li, Jing-Lin
AU  - Li JL
AD  - Department of Anesthesiology, The First Affiliated Hospital of Dalian Medical 
      University, Dalian 116011, Liaoning Province, China.
FAU - Sun, Zhong-Liang
AU  - Sun ZL
AD  - Department of Anesthesiology, The First Affiliated Hospital of Dalian Medical 
      University, Dalian 116011, Liaoning Province, China.
LA  - eng
PT  - Clinical Trial
PL  - United States
TA  - World J Clin Cases
JT  - World journal of clinical cases
JID - 101618806
PMC - PMC9923854
OTO - NOTNLM
OT  - Adverse event
OT  - Butorphanol
OT  - Colonoscopy
OT  - Effective concentration
OT  - Propofol
OT  - Sedated colonoscopy
OT  - Target-controlled infusion
COIS- Conflict-of-interest statement: All the authors report no relevant conflicts of 
      interest for this article.
EDAT- 2023/02/17 06:00
MHDA- 2023/02/17 06:01
PMCR- 2023/01/26
CRDT- 2023/02/16 02:19
PHST- 2022/10/12 00:00 [received]
PHST- 2022/12/19 00:00 [revised]
PHST- 2023/01/05 00:00 [accepted]
PHST- 2023/02/16 02:19 [entrez]
PHST- 2023/02/17 06:00 [pubmed]
PHST- 2023/02/17 06:01 [medline]
PHST- 2023/01/26 00:00 [pmc-release]
AID - 10.12998/wjcc.v11.i3.610 [doi]
PST - ppublish
SO  - World J Clin Cases. 2023 Jan 26;11(3):610-620. doi: 10.12998/wjcc.v11.i3.610.