Sedation During Endoscopy in Patients with Cirrhosis: Safety and Predictors of Adverse Events
| العنوان: | Sedation During Endoscopy in Patients with Cirrhosis: Safety and Predictors of Adverse Events |
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| المؤلفون: | Don C. Rockey, Alejandro L. Suarez, Jingwen Zhang, Jerome Edelson |
| المصدر: | Digestive Diseases and Sciences. 65:1258-1265 |
| بيانات النشر: | Springer Science and Business Media LLC, 2019. |
| سنة النشر: | 2019 |
| مصطلحات موضوعية: | Liver Cirrhosis, Male, Physiology, Midazolam, Sedation, Conscious Sedation, Colonoscopy, Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, Humans, Medicine, Laryngospasm, Adverse effect, Aged, Retrospective Studies, medicine.diagnostic_test, business.industry, Esophagogastroduodenoscopy, Gastroenterology, Endoscopy, Retrospective cohort study, Middle Aged, Analgesics, Opioid, Fentanyl, 030220 oncology & carcinogenesis, Anesthesia, Female, 030211 gastroenterology & hepatology, medicine.symptom, business, Propofol, Adjuvants, Anesthesia, Forecasting, medicine.drug |
| الوصف: | Sedation during endoscopy in cirrhotic patients is typically via moderate sedation, most commonly using a combination of a benzodiazepine (i.e., midazolam) and narcotic (i.e., fentanyl) or with propofol using monitored anesthesia care (MAC). Here, we examined the safety of moderate sedation and MAC in patients with cirrhosis. This retrospective cohort study of cirrhotic patients undergoing endoscopy from a large academic medical center between 2010 and 2014 examined extensive clinical data including the following: past history, physical findings, laboratory results, and procedural adverse events. Adverse events were defined a priori and included hypoxia, hypotension, bleeding, and death. We identified 2618 patients with cirrhosis who underwent endoscopic procedures; the mean age was 56 years, 36% were female, the mean Child–Pugh score was 9.3 (IQR: 8, 11), and Charlson Comorbidity Index score was 3.2 (IQR: 1, 4); 1157 had MAC; and 1461 had moderate sedation. There was no difference in the frequency of adverse events in MAC and moderate sedation groups, with a total of 15 adverse events (7/1157 MAC and 8/1461 moderate sedation). The most common procedure performed was esophagogastroduodenoscopy (EGD, n = 1667) and was associated with 10 adverse events. Overall, adverse events included bradycardia (1), hypoxia (7), bleeding (5), laryngospasm (1), and perforation (1). The frequency was similar for EGD, ERCP, and colonoscopy—each at a rate of 0.6%. Adverse events in cirrhotic patients undergoing endoscopy appeared to be similar with moderate sedation or MAC, and the frequency was the same for different types of procedures. |
| تدمد: | 1573-2568 0163-2116 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::53adc078dea5442539a91db4dc5f4ad4 https://doi.org/10.1007/s10620-019-05845-7 |
| حقوق: | CLOSED |
| رقم الأكسشن: | edsair.doi.dedup.....53adc078dea5442539a91db4dc5f4ad4 |
| قاعدة البيانات: | OpenAIRE |
Find this article in full text from Springer Verlag. | تدمد: | 15732568 01632116 |
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