PMID- 38128787
OWN - NLM
STAT- Publisher
LR  - 20240422
IS  - 1097-6779 (Electronic)
IS  - 0016-5107 (Linking)
DP  - 2023 Dec 19
TI  - Safety and tolerability outcomes of nonanesthesiologist-administered propofol 
      using target-controlled infusion in routine GI endoscopy.
LID - S0016-5107(23)03167-X [pii]
LID - 10.1016/j.gie.2023.12.023 [doi]
AB  - BACKGROUND AND AIMS: Nonanesthesiologist-administered propofol (NAAP) is 
      increasingly accepted, but data are limited on drug administration using 
      target-controlled infusion (TCI) in clinical practice. TCI adjusts the drug 
      infusion based on patient-specific parameters, maintaining a constant drug dose 
      to reduce the risk of adverse events (AEs) because of drug overdosing and to 
      enhance patient comfort. The aims of this study were to assess the rate of AEs 
      and to evaluate patient satisfaction with NAAP using TCI in a retrospective 
      cohort of 18,302 procedures. METHODS: Low-risk patients (American Society of 
      Anesthesiologists score I and II) undergoing outpatient GI endoscopic procedures, 
      including EGDs and colonoscopies, were sequentially enrolled at IRCCS San 
      Raffaele Hospital (Milan, Italy) between May 2019 and November 2021. RESULTS: 
      Data from 7162 EGDs and 11,140 colonoscopies were analyzed. Mean patient age was 
      59.1 +/- 14.8 years, and mean body mass index was 24.9 +/- 3.7 kg/m(2). The 
      male-to-female ratio was equal at 8798 (48.1%):9486 (51.9%). AEs occurred in 240 
      procedures (1.3%) out of the total cohort, with no differences between EGDs and 
      colonoscopies (100 [1.4%] and 140 [1.2%], respectively; P = .418). Most patients 
      (15,875 [98.9%]) indicated they would likely repeat the procedure with the same 
      sedation protocol. Age (odds ratio, 1.02; 95% confidence interval, 1.01-1.03; P < 
      .008) was the only independent factor associated with overall AEs. CONCLUSIONS: 
      NAAP using TCI is an effective and safe sedation method for routine endoscopy. 
      The proper propofol dosage based on individual patients and the presence of 
      trained operators are crucial for NAAP sedation management.
CI  - Copyright (c) 2023 American Society for Gastrointestinal Endoscopy. Published by 
      Elsevier Inc. All rights reserved.
FAU - Mandarino, Francesco Vito
AU  - Mandarino FV
AD  - Department of Gastroenterology and Gastrointestinal Endosco, Vita-Salute San 
      Raffaele University, Scientific Institute San Raffaele, Milan, Italy.
FAU - Fanti, Lorella
AU  - Fanti L
AD  - Department of Gastroenterology and Gastrointestinal Endosco, Vita-Salute San 
      Raffaele University, Scientific Institute San Raffaele, Milan, Italy.
FAU - Barchi, Alberto
AU  - Barchi A
AD  - Department of Gastroenterology and Gastrointestinal Endosco, Vita-Salute San 
      Raffaele University, Scientific Institute San Raffaele, Milan, Italy.
FAU - Sinagra, Emanuele
AU  - Sinagra E
AD  - Gastroenterology and Endoscopy Unit, Fondazione Istituto San Raffaele Giglio, 
      Cefalu, Italy.
FAU - Massimino, Luca
AU  - Massimino L
AD  - Department of Gastroenterology and Gastrointestinal Endosco, Vita-Salute San 
      Raffaele University, Scientific Institute San Raffaele, Milan, Italy.
FAU - Azzolini, Francesco
AU  - Azzolini F
AD  - Department of Gastroenterology and Gastrointestinal Endosco, Vita-Salute San 
      Raffaele University, Scientific Institute San Raffaele, Milan, Italy.
FAU - Viale, Edi
AU  - Viale E
AD  - Department of Gastroenterology and Gastrointestinal Endosco, Vita-Salute San 
      Raffaele University, Scientific Institute San Raffaele, Milan, Italy.
FAU - Napolitano, Maria
AU  - Napolitano M
AD  - Department of Gastroenterology and Gastrointestinal Endosco, Vita-Salute San 
      Raffaele University, Scientific Institute San Raffaele, Milan, Italy.
FAU - Salmeri, Noemi
AU  - Salmeri N
AD  - Gynecology and Obstetrics Unit, Vita-Salute San Raffaele University, Scientific 
      Institute San Raffaele, Milan, Italy.
FAU - Agostoni, Massimo
AU  - Agostoni M
AD  - Department of Anesthesiology, Vita-Salute San Raffaele University, Scientific 
      Institute San Raffaele, Milan, Italy.
FAU - Danese, Silvio
AU  - Danese S
AD  - Department of Gastroenterology and Gastrointestinal Endosco, Vita-Salute San 
      Raffaele University, Scientific Institute San Raffaele, Milan, Italy.
LA  - eng
PT  - Journal Article
DEP - 20231219
PL  - United States
TA  - Gastrointest Endosc
JT  - Gastrointestinal endoscopy
JID - 0010505
SB  - IM
COIS- Disclosure The following author disclosed financial relationships: S. Danese: 
      Speaker, consultant, and advisory board member for Schering-Plough, AbbVie, 
      Actelion, Alphawasserman, AstraZeneca, Cellerix, Cosmo Pharmaceuticals, Ferring, 
      Genentech, Grunenthal, Johnson and Johnson, Millenium Takeda, MSD, Nikkiso Europe 
      GmbH, Novo Nordisk, Nycomed, Pfizer, Pharmacosmos, UCB Pharma, and Vifor. All 
      other authors disclosed no financial relationships.
EDAT- 2023/12/22 00:42
MHDA- 2023/12/22 00:42
CRDT- 2023/12/21 19:28
PHST- 2023/08/11 00:00 [received]
PHST- 2023/11/18 00:00 [revised]
PHST- 2023/12/15 00:00 [accepted]
PHST- 2023/12/22 00:42 [pubmed]
PHST- 2023/12/22 00:42 [medline]
PHST- 2023/12/21 19:28 [entrez]
AID - S0016-5107(23)03167-X [pii]
AID - 10.1016/j.gie.2023.12.023 [doi]
PST - aheadofprint
SO  - Gastrointest Endosc. 2023 Dec 19:S0016-5107(23)03167-X. doi: 
      10.1016/j.gie.2023.12.023.