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Évaluation du risque de la sédation par propofol en endoscopie digestive par le gastroentérologue: revue de la littérature

Assessment of the risks of propofol sedation administered by a gastroenterologist in digestive endoscopy: literature review

  • Revue de la Littérature / Literature Review
  • Published:
Acta Endoscopica

Résumé

En France, l’anesthésie générale (AG) est le mode de sédation le plus souvent employé pour la sédation en endoscopie digestive. Le manque d’effectif et de disponibilité des anesthésistes peut entraîner dans certains centres d’endoscopie des dysfonctionnements. Cette revue de la littérature a pour objectif d’évaluer le risque de la sédation par du propofol sous la responsabilité de l’hépatogastroentérologue (HGE).

Abstract

In France, general anaesthesia is the most frequently used method of sedation for digestive endoscopy. The lack of numbers and of availability of anaesthetists may result in difficulties in some endoscopy units. The purpose of this literature review is to assess the risks of propofol sedation administered by the hepato-gastroenterologist.

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Références

  1. Grasset D, Morfoisse JJ, Seigneuric C. Conditions de réalisation et résultats des coloscopies réalisées dans les hôpitaux non universitaires: résultats d’une enquête transversale multicentrique de l’ANGH. Gastroenterol Clin Biol 2000;24(3):273–278.

    PubMed  CAS  Google Scholar 

  2. Standards of practice committee of the American Society for Gastrointestinal Endoscopy, Lichtenstein DR, Jagannath S, Baron TH, Anderson MA, Banerjee S, et al. Sedation and anesthesia in GI endoscopy. Gastrointest Endosc 2008;68(5):815–826.

    Article  PubMed  Google Scholar 

  3. Byrne MF, Chiba N, Singh H, Sadowski DC, Clinical affairs committee of the Canadian Association of Gastroenterology. Propofol use for sedation during endoscopy in adults: a Canadian Association of Gastroenterology Position Statement. Can J Gastroenterol 2008;22(5):457–459.

    PubMed  Google Scholar 

  4. Schreiber F, Working Group on Endoscopy, Austrian Society of Gastroenterology and Hepatology (OGGH). Austrian Society of Gastroenterology and Hepatology (OGGH)-guidelines on sedation and monitoring during gastrointestinal endoscopy. Endoscopy 2007;39(3):259–262.

    Article  PubMed  CAS  Google Scholar 

  5. Conigliaro R, Rossi A, Italian Society of Digestive Endoscopy (SIED) Sedation commission. Implementation of sedation guidelines in clinical practice in Italy: results of a prospective longitudinal multicenter study. Endoscopy 2006;38(11):1137–1143.

    Article  PubMed  CAS  Google Scholar 

  6. Statement on safe use of propofol approved by ASA house of delegates October 27, 2004. ASA practice guidelines for sedation and analgesia by non-anesthesiologists. Anesthesiology 2002;96:1004–1017.

    Article  Google Scholar 

  7. American Society of Anesthesiologists. Practice guidelines for sedation and analgesia by non-anesthesiologists. An updated report by the American Society of Anesthesiologists Task Force on Sedation and Analgesia by Non-Anesthesiologists. Anesthesiology 2002;96:1004–1017.

    Article  Google Scholar 

  8. Froehlich F, Gonvers JJ, Fried M. Conscious sedation, clinically relevant complications and monitoring of endoscopy: results of nationwide survey in Switzerland. Endoscopy 1994;26(2):231–234.

    Article  PubMed  CAS  Google Scholar 

  9. Heuss LT, Froehlich F, Beglinger C. Changing patterns of sedation and monitoring practice during endoscopy: results of nationwide survey in Switzerland. Endoscopy 2005;37(2):161–166.

    Article  PubMed  CAS  Google Scholar 

  10. Cohen LB, Wecsler JS, Gaetano JN, Benson AA, Miller KM, Durkalski V, et al. Endoscopic sedation in the United States: results from a nationwide survey. Am J Gastroenterol 2006;101(5):967–974.

    Article  PubMed  Google Scholar 

  11. Lienhart A, Auroy Y, Péquignot F, Benhamou D, Warszawski J, Bovet M, et al. Survey of anesthesia-related mortality in France. Anesthesiology 2006;105(6):1087–1097.

    Article  PubMed  Google Scholar 

  12. Farrow SC, Fowkes FG, Lunn JN, Robertson IB, Samuel P. Epidemiology in anaesthesia; II: factors affecting mortality in hospital. Br J Anaesth 1982;54(8):811–817.

    Article  PubMed  CAS  Google Scholar 

  13. Kawashima Y, Takahashi S, Suzuki M, Morita K, Irita K, Iwao Y, et al. Anesthesia-related mortality and morbidity over a 5-year period in 2,363,038 patients in Japan. Acta Anaesthesiol Scand 2003;47(7):809–817.

    Article  PubMed  CAS  Google Scholar 

  14. Arbous MS, Grobbee DE, van Kleef JW, de Lange JJ, Spoormans HH, Touw P, et al. Mortality associated with anaesthesia: a qualitative analysis to identify risk factors. Anaesthesia 2001;56(12):1141–1153.

    Article  PubMed  CAS  Google Scholar 

  15. Riphaus A, Stergiou N, Wehrmann T. Sedation with propofol for routine ERCP in high-risk octogenarians: a randomized, controlled study. Am J Gastroenterol 2005;100(9):1957–1963.

    Article  PubMed  CAS  Google Scholar 

  16. Paspatis GA, Manolaraki M, Xirouchakis G, Papanikolaou N, Chlouverakis G, Gritzali A. Synergistic sedation with midazolam and propofol versus midazolam and pethidine in colonoscopies: a prospective, randomized study. Am J Gastroenterol 2002;97(8):1963–1967.

    Article  PubMed  CAS  Google Scholar 

  17. Akcaboy ZN, Akcaboy EY, Albayrak D, Altinoren B, Dikmen B, Gogus N. Can remifentanil be a better choice than propofol for colonoscopy during monitored anesthesia care? Acta Anaesthesiol Scand 2006;50(6):736–741.

    Article  PubMed  CAS  Google Scholar 

  18. Patterson KW, Casey PB, Murray JP, O’Boyle CA, Cunningham AJ. Propofol sedation for outpatient upper gastrointestinal endoscopy: comparison with midazolam. Br J Anaesth 1991;67(1):108–111.

    Article  PubMed  CAS  Google Scholar 

  19. Hsieh YH, Chou AL, Lai YY, Chen BS, Sia SL, Chen IC, et al. Propofol alone versus propofol in combination with meperidine for sedation during colonoscopy. J Clin Gastroenterol 2009;43(8):753–757.

    Article  PubMed  CAS  Google Scholar 

  20. Ong WC, Santosh D, Lakhtakia S, Reddy DN. A randomized controlled trial on use of propofol alone versus propofol with midazolam, ketamine, and pentazocine “sedato-analgesic cocktail” for sedation during ERCP. Endoscopy 2007;39(9):807–812

    Article  PubMed  CAS  Google Scholar 

  21. Rudner R, Jalowiecki P, Kawecki P, Gonciarz M, Mularczyk A, Petelenz M. Conscious analgesia/sedation with remifentanil and propofol versus total intravenous anesthesia with fentanyl, midazolam, and propofol for outpatient colonoscopy. Gastrointest Endosc 2003;57(6):657–663.

    Article  PubMed  Google Scholar 

  22. Carlsson U, Grattidge P. Sedation for upper gastrointestinal endoscopy: a comparative study of propofol and midazolam. Endoscopy 1995;27(3):240–243.

    Article  PubMed  CAS  Google Scholar 

  23. Wehrmann T, Kokabpick S, Lembcke B, Caspary WF, Seifert H. Efficacy and safety of intravenous propofol sedation during routine ERCP: a prospective, controlled study. Gastrointest Endosc 1999;49(6):677–683.

    Article  PubMed  CAS  Google Scholar 

  24. Vargo JJ, Zuccaro G Jr, Dumot JA, Shermock KM, Morrow JB, Conwell DL, et al. Gastroenterologist-administered propofol versus meperidine and midazolam for advanced upper endoscopy: a prospective, randomized trial. Gastroenterology 2002;123(1):8–16.

    Article  PubMed  CAS  Google Scholar 

  25. Reimann FM, Samson U, Derad I, Fuchs M, Schiefer B, Stange EF. Synergistic sedation with low-dose midazolam and propofol for colonoscopies. Endoscopy 2000;32(3):239–244.

    Article  PubMed  CAS  Google Scholar 

  26. Sipe BW, Rex DK, Latinovich D, Overley C, Kinser K, Bratcher L, et al. Propofol versus midazolam/meperidine for outpatient colonoscopy: administration by nurses supervised by endoscopists. Gastrointest Endosc 2002;55(7):815–825.

    Article  PubMed  Google Scholar 

  27. Weston BR, Chadalawada V, Chalasani N, Kwo P, Overley CA, Symms M, et al. Nurse-administered propofol versus midazolam and meperidine for upper endoscopy in cirrhotic patients. Am J Gastroenterol 2003;98(11):2440–2447.

    Article  PubMed  CAS  Google Scholar 

  28. Ulmer BJ, Hansen JJ, Overley CA, Symms MR, Chadalawada V, Liangpunsakul S, et al. Propofol versus midazolam/fentanyl for outpatient colonoscopy: administration by nurses supervised by endoscopists. Clin Gastroenterol Hepatol 2003;1(6):425–432.

    Article  PubMed  CAS  Google Scholar 

  29. VanNatta ME, Rex DK. Propofol alone titrated to deep sedation versus propofol in combination with opioids and/or benzodiazepines and titrated to moderate sedation for colonoscopy. Am J Gastroenterol 2006;101(10):2209–2217.

    Article  PubMed  CAS  Google Scholar 

  30. Kongkam P, Rerknimitr R, Punyathavorn S, Sitthi-Amorn C, Ponauthai Y, Prempracha N, et al. Propofol infusion versus intermittent meperidine and midazolam injection for conscious sedation in ERCP. J Gastrointestin Liver Dis 2008;17(3):291–297.

    PubMed  Google Scholar 

  31. Schilling D, Rosenbaum A, Schweizer S, Richter H, Rumstadt B. Sedation with propofol for interventional endoscopy by trained nurses in high-risk octogenarians: a prospective, randomized, controlled study. Endoscopy 2009;41(4):295–298.

    Article  PubMed  CAS  Google Scholar 

  32. Seifert H, Schmitt TH, Gültekin T, Caspary WF, Wehrmann T. Sedation with propofol plus midazolam versus propofol alone for interventional endoscopic procedures: a prospective, randomized study. Aliment Pharmacol Ther 2000;14(9):1207–1214.

    Article  PubMed  CAS  Google Scholar 

  33. Dewitt J, McGreevy K, Sherman S, Imperiale TF. Nurseadministered propofol sedation compared with midazolam and meperidine for EUS: a prospective, randomized trial. Gastrointest Endosc 2008;68(3):499–509.

    Article  PubMed  Google Scholar 

  34. Singh H, Poluha W, Cheung M, Choptain N, Baron KI, Taback SP. Propofol for sedation during colonoscopy. Cochrane Database Syst Rev 2008;(4):CD006268.

    PubMed  Google Scholar 

  35. Qadeer MA, Vargo JJ, Khandwala F, Lopez R, Zuccaro G. Propofol versus traditional sedative agents for gastrointestinal endoscopy: a meta-analysis. Clin Gastroenterol Hepatol 2005;3(11):1049–1056.

    Article  PubMed  CAS  Google Scholar 

  36. Heuss LT, Froehlich F, Beglinger C. Changing patterns of sedation and monitoring practice during endoscopy: results of nationwide survey in Switzerland. Endoscopy 2005;37(2):161–166.

    Article  PubMed  CAS  Google Scholar 

  37. Clarke AC, Hillman LC. Does the use of propofol require a specialist anesthetist? Endoscopy 2001;33(1):95–96.

    PubMed  CAS  Google Scholar 

  38. Rex DK, Deenadayalu VP, Eid E, Imperiale TF, Walker JA, Sandhu K, et al. Endoscopist-directed administration of propofol: a worldwide safety experience. Gastroenterology 2009;137(4):1229–1237.

    Article  PubMed  Google Scholar 

  39. Thompson AM, Wright DJ, Murray W, Ritchie GL, Burton HD, Stonebridge PA. Analysis of 153 deaths after upper gastrointestinal endoscopy: room for improvement? Surg Endosc 2004;18(1):22–25.

    Article  PubMed  CAS  Google Scholar 

  40. Bailey PL, Pace NL, Ashburn MA, Moll JW, East KA, Stanley TH. Frequent hypoxemia and apnea after sedation with midazolam and fentanyl. Anesthesiology 1990;73(5):826–830.

    Article  PubMed  CAS  Google Scholar 

  41. Sharma VK, Nguyen CC, Crowell MD, Lieberman DA, de Garmo P, Fleischer DE. A national study of cardiopulmonary unplanned events after GI endoscopy. Gastrointest Endosc 2007;66:27–34.

    Article  PubMed  Google Scholar 

  42. Laquière A, Artigue F, Monzy F, Bony C, Dapoigny M, Bommelaer G. Sedation using propofol under the gastroenterologist’s supervision during a colonoscopy: results of a prospective, randomized and controlled study GUT-Endoscopy-Supplement no 2 vol. 38-A234-WED-G-320;2006.

  43. Cohen LB, Delegge MH, Aisenberg J, Brill JV, Inadomi JM, Kochman ML, et al. AGA Institute review of endoscopic sedation. Gastroenterology 2007;133(2):675–701.

    Article  PubMed  CAS  Google Scholar 

  44. Jung M, Hofmann C, Kiesslich R, Brackertz A. Improved sedation in diagnostic and therapeutic ERCP: propofol is an alternative to midazolam. Endoscopy 2000;32(3):233–238.

    Article  PubMed  CAS  Google Scholar 

  45. Wehrmann T, Grotkamp J, Stergiou N, Riphaus A, Kluge A, Lembcke B, et al. Electroencephalogram monitoring facilitates sedation with propofol for routine ERCP: a randomized, controlled trial. Gastrointest Endosc 2002;56(6):817–824.

    Article  PubMed  Google Scholar 

  46. Krugliak P, Ziff B, Rusabrov Y, Rosenthal A, Fich A, Gurman GM. Propofol versus midazolam for conscious sedation guided by processed EEG during endoscopic retrograde cholangiopancreatography: a prospective, randomized, double-blind study. Endoscopy 2000;32(9):677–682.

    Article  PubMed  CAS  Google Scholar 

  47. Riphaus A, Stergiou N, Wehrmann T. Sedation with propofol for routine ERCP in high-risk octogenarians: a randomized, controlled study. Am J Gastroenterol 2005;100(9):1957–1963.

    Article  PubMed  CAS  Google Scholar 

  48. Wehrmann T, Riphaus A. Sedation with propofol for interventional endoscopic procedures: a risk factor analysis. Scand J Gastroenterol 2008;43(3):368–374.

    Article  PubMed  CAS  Google Scholar 

  49. Heuss LT, Schnieper P, Drewe J, Pflimlin E, Beglinger C. Risk stratification and safe administration of propofol by registered nurses supervised by the gastroenterologist: a prospective observational study of more than 2000 cases. Gastrointest Endosc 2003;57(6):664–671.

    Article  PubMed  Google Scholar 

  50. Vargo JJ, Holub JL, Faigel DO, Lieberman DA, Eisen GM. Risk factors for cardiopulmonary events during propofol-mediated upper endoscopy and colonoscopy. Aliment Pharmacol Ther 2006;24(6):955–963.

    Article  PubMed  CAS  Google Scholar 

  51. Assy N, Rosser BG, Grahame GR, Minuk GY. Risk of sedation for upper GI endoscopy exacerbating subclinical hepatic encephalopathy in patients with cirrhosis. Gastrointest Endosc 1999;49(6):690–694.

    Article  PubMed  CAS  Google Scholar 

  52. Vasudevan AE, Goh KL, Bulgiba AM. Impairment of psychomotor responses after conscious sedation in cirrhotic patients undergoing therapeutic upper GI endoscopy. Am J Gastroenterol 2002;97(7):1717–1721.

    Article  PubMed  CAS  Google Scholar 

  53. American society of anesthesiologists task force on sedation and analgesia by non-anesthesiologists. Practice guidelines for sedation and analgesia by non-anesthesiologists. Anesthesiology 2002;96:1004–1017.

    Article  Google Scholar 

  54. Carrasco G, Molina R, Costa J, Soler JM, Cabré L. Propofol versus midazolam in short-, medium-, and long-term sedation critically ill patient. A cost benefit analysis. Chest 1993;103(2):557–564.

    Article  PubMed  CAS  Google Scholar 

  55. Gamble JA, Kawar P, Dundee JW, Moore J, Briggs LP. Evaluation of midazolam as a antravenous induction agent. Anaesthesia 1981;36(9):868–873.

    Article  PubMed  CAS  Google Scholar 

  56. Patterson KW, Casey PB, Murray JP, O’Boyle CA, Cunningham AJ. Propofol sedation for outpatient upper gastrointestinal endoscopy: comparison with midazolam. Br J Anaesth 1991;67(1):108–111.

    Article  PubMed  CAS  Google Scholar 

  57. Bailey PL, Pace NL, Ashburn MA, Moll JW, East KA, Stanley TH. Frequent hypoxemia and apnea after sedation with midazolam and fentanyl. Anesthesiology 1990;73(5):826–830.

    Article  PubMed  CAS  Google Scholar 

  58. Yusoff IF, Raymond G, Sahai AV. Endoscopist administered propofol for upper-GI EUS is safe and effective: a prospective study in 500 patients. Gastrointest Endosc 2004;60(3):356–360.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Service d’endoscopie digestive, Hôpital privé Saint Joseph, Boulevard de Louvain, F-13825, Marseille, France

    C. Boustière

  2. Service des maladies de l’appareil digestif, CHU de Pontchaillou, 2 rue Henri Le Guilloux, F-35033, Rennes cedex 9, France

    D. Heresbach

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  1. A. Laquière
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  2. C. Boustière
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  3. D. Heresbach
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Laquière, A., Boustière, C. & Heresbach, D. Évaluation du risque de la sédation par propofol en endoscopie digestive par le gastroentérologue: revue de la littérature. Acta Endosc 41, 29–36 (2011). https://doi.org/10.1007/s10190-010-0133-9

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  • DOI: https://doi.org/10.1007/s10190-010-0133-9

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