The efficacy of non-anesthesiologist-administered propofol sedation with a target-controlled infusion system during double-balloon endoscopic retrograde cholangiopancreatography

Miyamoto, Kazuya; Matsumoto, Kazuyuki; Obata, Taisuke; Sato, Ryosuke; Matsumi, Akihiro; Morimoto, Kosaku; Ogawa, Taiji; Terasawa, Hiroyuki; Fujii, Yuki; Yamazaki, Tatsuhiro; Uchida, Daisuke; Horiguchi, Shigeru; Tsutsumi, Koichiro; Kato, Hironari; Otsuka, Motoyuki

doi:10.1186/s12876-023-02936-8

Permalink : https://ousar.lib.okayama-u.ac.jp/65930

ID	65930
フルテキストURL	fulltext.pdf 1.19 MB
著者	Miyamoto, Kazuya Department of Gastroenterology and Hepatology, Okayama University Hospital Matsumoto, Kazuyuki Department of Gastroenterology and Hepatology, Okayama University Hospital ORCID Kaken ID publons Obata, Taisuke Department of Gastroenterology and Hepatology, Okayama University Hospital Sato, Ryosuke Department of Gastroenterology and Hepatology, Okayama University Hospital Matsumi, Akihiro Department of Gastroenterology and Hepatology, Okayama University Hospital Morimoto, Kosaku Department of Gastroenterology and Hepatology, Okayama University Hospital Ogawa, Taiji Department of Gastroenterology and Hepatology, Okayama University Hospital Terasawa, Hiroyuki Department of Gastroenterology and Hepatology, Okayama University Hospital Fujii, Yuki Department of Gastroenterology and Hepatology, Okayama University Hospital Yamazaki, Tatsuhiro Department of Gastroenterology and Hepatology, Okayama University Hospital Uchida, Daisuke Department of Gastroenterology and Hepatology, Okayama University Hospital ORCID Kaken ID researchmap Horiguchi, Shigeru Department of Gastroenterology and Hepatology, Okayama University Hospital Tsutsumi, Koichiro Department of Gastroenterology and Hepatology, Okayama University Hospital ORCID Kaken ID researchmap Kato, Hironari Department of Gastroenterology and Hepatology, Okayama University Hospital ORCID Kaken ID researchmap Otsuka, Motoyuki Department of Gastroenterology and Hepatology, Okayama University Hospital
抄録	Background　The sedation method used during double-balloon endoscopic retrograde cholangiopancreatography (DB-ERCP) differs among countries and/or facilities, and there is no established method. This study aimed to evaluate the efficacy of non-anesthesiologist-administered propofol (NAAP) sedation using a target-controlled infusion (TCI) system during DB-ERCP. Methods　This retrospective study was conducted between May 2017 and December 2020 at an academic center. One hundred and fifty-six consecutive patients who underwent DB-ERCP were sedated by gastroenterologists using diazepam (n = 77) or propofol with a TCI system (n = 79), depending on the period. The primary endpoint was a comparison of poor sedation rates between the two groups. Poor sedation was defined as a condition requiring the use of other sedative agents or discontinuation of the procedure. Secondary endpoints were sedation-related adverse events and risk factors for poor sedation. Results　Poor sedation occurred significantly more often in the diazepam sedation group (diazepam sedation, n = 12 [16%] vs. propofol sedation, n = 1 [1%]; P = 0.001). Vigorous body movements (3 or 4) (diazepam sedation, n = 40 [52%] vs. propofol sedation, n = 28 [35%]; P = 0.038) and hypoxemia (< 85%) (diazepam sedation, n = 7 [9%] vs. propofol sedation, n = 1 [1%]; P = 0.027) occurred significantly more often in the diazepam sedation group. In the multivariate analysis, age < 70 years old (OR, 10.26; 95% CI, 1.57-66.98; P = 0.015), BMI = 25 kg/m2 (OR, 11.96; 95% CI, 1.67-85.69; P = 0.014), and propofol sedation (OR, 0.06; 95% CI, 0.01-0.58; P = 0.015) were associated factors for poor sedation. Conclusions　NAAP sedation with the TCI system during DB-ERCP was safer and more effective than diazepam sedation.
キーワード	Balloon-assisted endoscopy Propofol Diazepam Sedation
備考	The version of record of this article, first published in BMC Gastroenterology, is available online at Publisher’s website: http://dx.doi.org/10.1186/s12876-023-02936-8
発行日	2023-09-04
出版物タイトル	BMC Gastroenterology
巻	23巻
号	1号
出版者	BMC
開始ページ	296
ISSN	1471-230X
資料タイプ	学術雑誌論文
言語	英語
OAI-PMH Set	岡山大学
著作権者	© The Author(s) 2023.
論文のバージョン	publisher
PubMed ID	37667224
DOI	10.1186/s12876-023-02936-8
Web of Science KeyUT	001063014700002
関連URL	isVersionOf https://doi.org/10.1186/s12876-023-02936-8
ライセンス	http://creativecommons.org/licenses/by/4.0/
Citation	Miyamoto, K., Matsumoto, K., Obata, T. et al. The efficacy of non-anesthesiologist-administered propofol sedation with a target-controlled infusion system during double-balloon endoscopic retrograde cholangiopancreatography. BMC Gastroenterol 23, 296 (2023). https://doi.org/10.1186/s12876-023-02936-8
助成機関名	Japan Society for the Promotion of Science
助成番号	20K17050