Department of Anesthesiology and ICU, Faculty of Medicine, Aristotle University of Thessaloniki, University Campus, 54124, Thessaloniki, Greece.
Department of General Surgery, York Teaching Hospital, NHS Foundation Trust, Wigginton Road, York, North Yorkshire, YO31 8HE, UK.
Obes Surg. 2019 Dec;29(12):3882-3890. doi: 10.1007/s11695-019-04075-0.
Sedation is considered as a prerequisite for the safe and effective conclusion of Bioenterics Intragastric Balloon (BIB) removal (our aim was to ascertain the most appropriate body size scalars for propofol dosing and assess the efficacy and safety of a sedative approach involving the infusion of propofol for BIB removal.
Retrospective analysis of prospectively collected data of 414 adults scheduled to undergo BIB removal. Our primary end-point was to delineate the relationship between propofol dosing and body size descriptors namely body mass index, total body weight, ideal body weight, lean body weight (LBW) and normalized LBW. Sedative efficacy of this practice, anesthesia or procedural-related adverse events and patients' satisfaction level served as secondary outcome parameters.
Propofol dose (mg/kg/min) was positively related to all body weight descriptors in an important manner (p < 0.001). Among them, LBW was singled out as the body size descriptor to best capture the appropriate needs of propofol (R = 0.432; p = 0.000). Hypoxemia, hemodynamic compromise, gastroesophageal reflux or moderate movement occurred rarely; all of them were readily reversed. The majority of participants had no recollection of the noxious phase of the procedure or declared at least adequately satisfied from the experience (84% and 95%, respectively).
LBW could serve as relatively more accurate dosing scalar compared to actual or ideal body weight descriptors, in obese individuals undergoing BIB removal under propofol sedation. The conscious/deep sedation based on propofol infusion emerges as a feasible and efficacious sedative approach for this procedure.
镇静被认为是安全有效地完成生物胃内球囊（BIB）去除术的前提条件（我们的目的是确定最适合丙泊酚给药的体型标度，并评估涉及丙泊酚输注的镇静方法在 BIB 去除术中的疗效和安全性。
回顾性分析 414 例计划行 BIB 去除术的成年人的前瞻性收集数据。我们的主要终点是描绘丙泊酚剂量与体型描述符（即体重指数、总体重、理想体重、瘦体重（LBW）和标准化 LBW）之间的关系。这种做法的镇静效果、麻醉或程序相关的不良事件以及患者的满意度水平是次要的结果参数。
丙泊酚剂量（mg/kg/min）与所有体重描述符呈显著正相关（p<0.001）。其中，LBW 是最能捕捉丙泊酚适当需求的体型描述符（R=0.432；p=0.000）。低氧血症、血流动力学不稳定、胃食管反流或中度运动很少发生；所有这些都很容易逆转。大多数参与者对该程序的有害阶段没有记忆，或者至少对该体验感到满意（分别为 84%和 95%）。
在接受丙泊酚镇静的肥胖个体中，LBW 可以作为比实际或理想体重描述符更准确的给药标度。基于丙泊酚输注的清醒/深度镇静是该程序的一种可行且有效的镇静方法。
