دورية أكاديمية
Safety and risk factors for difficult endoscopist-directed ERCP sedation in daily practice: a hospital-based case-control study
| العنوان: | Safety and risk factors for difficult endoscopist-directed ERCP sedation in daily practice: a hospital-based case-control study |
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| المؤلفون: | Enrique Pérez-Cuadrado-Robles, Abel González-Ramírez, Ángel Lancho-Seco, Eva Martí-Marqués, Andrés Dacal-Rivas, Elena Castro-Ortiz, Roberto González-Soler, Beatriz Álvarez-Suárez, Dolores Tardáguila-García, Alina López-Baz, Alexia Fernández-López, Leopoldo López-Roses |
| المصدر: | Revista Espanola de Enfermedades Digestivas, Vol 108, Iss 5, Pp 240-245 |
| بيانات النشر: | Aran Ediciones. |
| المجموعة: | LCC:Diseases of the digestive system. Gastroenterology |
| مصطلحات موضوعية: | endoscopic retrograde cholangiopancreatography (ercp), sedation, non-anesthesiologist administration of propofol (naap), endoscopy, Diseases of the digestive system. Gastroenterology, RC799-869 |
| الوصف: | Background: There are limited data concerning endoscopist-directed endoscopic retrograde cholangiopancreatography deep sedation. The aim of this study was to establish the safety and risk factors for difficult sedation in daily practice. Patients and methods: Hospital-based, frequency matched case-control study. All patients were identified from a database of 1,008 patients between 2014 and 2015. The cases were those with difficult sedations. This concept was defined based on the combination of the receipt of high-doses of midazolam or propofol, poor tolerance, use of reversal agents or sedation-related adverse events. The presence of different factors was evaluated to determine whether they predicted difficult sedation. Results: One-hundred and eighty-nine patients (63 cases, 126 controls) were included. Cases were classified in terms of high-dose requirements (n = 35, 55.56%), sedation-related adverse events (n = 14, 22.22%), the use of reversal agents (n = 13, 20.63%) and agitation/discomfort (n = 8, 12.7%). Concerning adverse events, the total rate was 1.39%, including clinically relevant hypoxemia (n = 11), severe hypotension (n = 2) and paradoxical reactions to midazolam (n = 1). The rate of hypoxemia was higher in patients under propofol combined with midazolam than in patients with propofol alone (2.56% vs. 0.8%, p < 0.001). Alcohol consumption (OR: 2.674 [CI 95%: 1.098-6.515], p = 0.030), opioid consumption (OR: 2.713 [CI 95%: 1.096-6.716], p = 0.031) and the consumption of other psychoactive drugs (OR: 2.015 [CI 95%: 1.017-3.991], p = 0.045) were confirmed to be independent risk factors for difficult sedation. Conclusions: Endoscopist-directed deep sedation during endoscopic retrograde cholangiopancreatography is safe. The presence of certain factors should be assessed before the procedure to identify patients who are high-risk for difficult sedation. |
| نوع الوثيقة: | article |
| وصف الملف: | electronic resource |
| اللغة: | English Spanish; Castilian |
| تدمد: | 1130-0108 |
| Relation: | http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S1130-01082016000500002&lng=en&tlng=en; https://doaj.org/toc/1130-0108 |
| URL الوصول: | https://doaj.org/article/b1e21ce0348d4638b3b9b72ef56ce653 |
| رقم الأكسشن: | edsdoj.b1e21ce0348d4638b3b9b72ef56ce653 |
| قاعدة البيانات: | Directory of Open Access Journals |
| تدمد: | 11300108 |
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