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Etomidate plus propofol versus propofol alone for sedation during gastroscopy: a randomized prospective clinical trial

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Abstract

Background and aims

Sedation with propofol alone during gastroscopy has many side effects. Etomidate has advantages in terms of circulation and respiration compared to propofol. We hypothesized that etomidate plus propofol during gastroscopy would be more safe and effective than propofol alone.

Methods

Four hundred (n = 400) patients were randomly divided into a propofol group (P group) and a etomidate plus propofol group (EP group). The P group was given the first dose of 1 % propofol 1 mg/kg before gastroscopy, and the EP group was given 1 % propofol 0.5 mg/kg plus etomidate 0.1 mg/kg. Repeated doses of 10–20 mg propofol or 5–10 mg propofol plus 1–2 mg etomidate were administered to maintain an adequate level of sedation. The sedation depth was maintained by bispectral index value of 40–60.

Results

The EP group had a lower incidence of systolic hypotension (13.0 vs. 32.5 %; P < 0.0001), bradycardia (8.5 vs. 16.5 %; P = 0.0226), mild hypoxemia (6.5 vs. 18.0 %; P = 0.0007), and severe hypoxemia (2.5 vs. 10.0 %; P = 0.0031) compared to the P group. Also, the satisfaction of anesthetist and gastroscopist with EP was higher than that of P group (P < 0.0001; P = 0.018, respectively).

Conclusion

Etomidate plus propofol had few effects on respiration and circulation in patients undergoing gastroscopy and was more safe and effective than propofol alone.

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Acknowledgments

I would like to express my sincere thanks to all those who have lent me hands in course of writing this paper. I would like to express my gratitude to my workmates in Wuhan General Hospital who provided references and information. Without their help, it would have been more difficult to complete this study.

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Authors and Affiliations

  1. Department of Anesthesiology, Wuhan General Hospital of Guangzhou Command, Wuhan, 430070, Hubei, People’s Republic of China

    Xiang Zhou, Bi-Xi Li, Li-Min Chen, Jun Tao, Sui Zhang, Meng Ji, Ming-Chun Wu, Min Chen, Yan-Hui Zhang, Guo-Shen Gan & Xiao-Yang Song

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  1. Xiang Zhou
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Correspondence to Bi-Xi Li or Xiao-Yang Song.

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Xiang Zhou, Bi-Xi Li, Li-Min Chen, Jun Tao, Sui Zhang, Meng Ji, Ming-Chun Wu, Min Chen, Yan-Hui Zhang, Guo-Shen Gan, and Xiao-Yang Song have no conflicts of interest or financial ties to disclose.

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Zhou, X., Li, BX., Chen, LM. et al. Etomidate plus propofol versus propofol alone for sedation during gastroscopy: a randomized prospective clinical trial. Surg Endosc 30, 5108–5116 (2016). https://doi.org/10.1007/s00464-016-4861-6

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