Department of Gastroenterology, Hospital Xeral-Calde, Lugo, Spain.
Rev Esp Enferm Dig. 2010 Apr;102(4):249-56. doi: 10.4321/s1130-01082010000400005.
propofol is a hypnotic used with increasing frequency for sedation during endoscopic procedures. Most of the reports published related with its employment by non-anaesthesiologists, refers to basic endoscopy, with little reference to its use in advanced endoscopy.
to evaluate the efficacy and safety of propofol sedation administered by endoscopists, while performing percutaneous endoscopic gastrostomy, an advanced technique that is usually performed in high anesthetic level risk patients.
prospective study of a series of endoscopic gastrostomy performed consecutively in our department; the sedation was carried out exclusively with propofol. The staff in the room consisted of two medical gastroenterologists, a nurse and a nursing assistant. Propofol was administered by bolus doses adjusted to patient weight. Arterial oxygen saturation, heart rate and blood pressure were monitored; respiratory activity was monitored visually by observing respiratory excursions of the patient.
we included 47 patients, with an average age of 82 years. 87% were ASA III and the rest, ASA IV. The mean dose of propofol was 51 mgr. Complications were recorded: 8 cases of desaturation and two of hypotension, all of them minor and quickly reversible. All procedures were carried out successfully, at a median time of 8 minutes.
the propofol sedation carried out by non-anaesthesiologist trained staff, seems to appear as a safe and effective procedure while performing percutaneous endoscopic gastrostomy.
异丙酚是一种常用于内镜检查镇静的催眠药物，越来越频繁地被使用。大多数与非麻醉医生使用相关的报告，都与基础内镜检查有关，很少涉及在高级内镜检查中的应用。
评估内镜医生在进行经皮内镜胃造口术时使用异丙酚镇静的疗效和安全性，这是一种高级技术，通常在高麻醉风险患者中进行。
对我院连续进行的一系列内镜胃造口术进行前瞻性研究；镇静仅使用异丙酚。房间内的工作人员由两名医学胃肠病学家、一名护士和一名护理助理组成。异丙酚通过调整患者体重的推注剂量给药。监测动脉血氧饱和度、心率和血压；通过观察患者呼吸运动的起伏来监测呼吸活动。
我们纳入了 47 名患者，平均年龄为 82 岁。87%为 ASA III 级，其余为 ASA IV 级。异丙酚的平均剂量为 51 毫克。记录了并发症：8 例患者出现血氧饱和度下降和 2 例低血压，均为轻度且迅速可逆。所有操作均成功进行，中位时间为 8 分钟。
由经过培训的非麻醉医生团队进行的异丙酚镇静，在进行经皮内镜胃造口术时似乎是一种安全有效的操作。
