Comparison of Propofol Deep Sedation Versus Moderate Sedation During Endosonography
- D. S. NayarAffiliated withGastroenterology Associates of Central Jersey
- , W. G. GuthrieAffiliated withDivision of Gastroenterology, SUNY-Downstate Medical Center Email author
- , A. GoodmanAffiliated withDivision of Gastroenterology, SUNY-Downstate Medical Center
- , Y. LeeAffiliated withDivision of Gastroenterology, SUNY-Downstate Medical Center
- , M. FeuermanAffiliated withDepartment of Biostatistics, Winthrop University Hospital
- , L. ScheinbergAffiliated withDepartment of Anesthesiology, Winthrop University Hospital
- , F. G. GressAffiliated withDivision of Gastroenterology, SUNY-Downstate Medical Center
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The purposes of this study are: (1) to prospectively evaluate clinically relevant outcomes including sedation-related complications for endoscopic ultrasound (EUS) procedures performed with the use of propofol deep sedation administered by monitored anesthesia care (MAC), and (2) to compare these results with a historical case–control cohort of EUS procedures performed using moderate sedation provided by the gastrointestinal (GI) endoscopist.
Materials And Methods
Patients referred for EUS between January 1, 2001 and December 31, 2002 were enrolled. Complication rates for EUS using MAC sedation were observed and also compared with a historical case–control cohort of EUS patients who received meperidine/midazolam for moderate sedation, administered by the GI endoscopist. Logistic regression analysis was used to isolate possible predictors of complications.
A total of 1,000 patients underwent EUS with propofol sedation during the period from January 1, 2001 through December 31, 2002 (mean age 64 years, 53% female). The distribution of EUS indications based on the primary area of interest was: 170 gastroduodenal, 92 anorectal, 508 pancreaticohepatobiliary, 183 esophageal, and 47 mediastinal. The primary endpoint of the study was development of sedation-related complications occurring during a performed procedure. A total of six patients experienced complications: duodenal perforation (one), hypotension (one), aspiration pneumonia (one), and apnea requiring endotracheal intubation (three). The complication rate with propofol was 0.60%, compared with 1% for the historical case–control (meperidine/midazolam moderate sedation) group.
There does not appear to be a significant difference between complication rates for propofol deep sedation with MAC and meperidine/midazolam administered for moderate sedation.
KeywordsEndoscopic ultrasound EUS Propofol Deep sedation Complications
- Comparison of Propofol Deep Sedation Versus Moderate Sedation During Endosonography
Digestive Diseases and Sciences
Volume 55, Issue 9 , pp 2537-2544
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- Springer US
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- Endoscopic ultrasound
- Deep sedation
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- Author Affiliations
- 1. Gastroenterology Associates of Central Jersey, Edison, NJ, USA
- 4. Division of Gastroenterology, SUNY-Downstate Medical Center, 450 Clarkson Ave, Brooklyn, NY, 11203, USA
- 2. Department of Biostatistics, Winthrop University Hospital, Mineola, NY, USA
- 3. Department of Anesthesiology, Winthrop University Hospital, Mineola, NY, USA