Kanno Yoshihide, Ohira Tetsuya, Harada Yoshihiro, Koshita Shinsuke, Ogawa Takahisa, Kusunose Hiroaki, Koike Yoshiki, Yamagata Taku, Sakai Toshitaka, Masu Kaori, Yonamine Keisuke, Miyamoto Kazuaki, Tanaka Megumi, Shimada Tomohiro, Kozakai Fumisato, Endo Kazuki, Okano Haruka, Komabayashi Daichi, Shimizu Takeshi, Suzuki Shohei, Ito Kei
Department of Gastroenterology, Sendai City Medical Center, Sendai, Japan.
Clin Endosc. 2021 May;54(3):340-347. doi: 10.5946/ce.2020.138. Epub 2020 Dec 11.
BACKGROUND/AIMS: The aim of this study was to evaluate the safety of sedation with propofol as an alternative to benzodiazepine drugs in outpatient endoscopy.
In this prospective study, examinees who underwent outpatient endoscopy under propofol sedation and submitted a nextday questionnaire with providing informed consent were evaluated. Periprocedural acute responses, late adverse events within 24 hours, and examinee satisfaction were evaluated.
Among the 4,122 patients who received propofol in the 17,978 outpatient-based endoscopic examinations performed between November 2016 and March 2018, 2,305 eligible examinees (esophagogastroduodenoscopy for 1,340, endoscopic ultrasonography for 945, and total colonoscopy for 20) were enrolled, and their responses to a questionnaire were analyzed. The mean propofol dose was 69.6±24.4 mg (range, 20-200 mg). Diazepam, midazolam, and/or pentazocine in combination with propofol was administered to 146 examinees. Mild oxygen desaturation was observed in 59 examinees (2.6%); and mild bradycardia, in 2 (0.09%). Other severe reactions or late events did not occur. After eliminating 181 invalid responses, 97.7% (2,065/2,124) of the patients desired propofol sedation in future examinations.
Propofol sedation was found to be safe-without severe adverse events or accidents-for outpatient endoscopy on the basis of the patients' next-day self-evaluation. Given the high satisfaction level, propofol sedation might be an ideal tool for painless endoscopic screening.
背景/目的：本研究旨在评估丙泊酚镇静作为门诊内镜检查中苯二氮䓬类药物替代方案的安全性。
在这项前瞻性研究中，对在丙泊酚镇静下接受门诊内镜检查并在提供知情同意后提交次日问卷的受检者进行评估。评估围手术期急性反应、24小时内的晚期不良事件以及受检者满意度。
在2016年11月至2018年3月期间进行的17978例门诊内镜检查中，有4122例患者接受了丙泊酚治疗，其中2305例符合条件的受检者（1340例进行了食管胃十二指肠镜检查，945例进行了内镜超声检查，20例进行了全结肠镜检查）被纳入研究，并对他们的问卷回复进行了分析。丙泊酚的平均剂量为69.6±24.4mg（范围为20 - 200mg）。146例受检者同时使用了地西泮、咪达唑仑和/或喷他佐辛与丙泊酚联合使用。59例受检者（2.6%）出现轻度氧饱和度降低；2例（0.09%）出现轻度心动过缓。未发生其他严重反应或晚期事件。在剔除181份无效回复后，97.7%（2065/2124）的患者希望在未来检查中使用丙泊酚镇静。
根据患者次日的自我评估，丙泊酚镇静在门诊内镜检查中被发现是安全的，没有严重不良事件或事故。鉴于高满意度，丙泊酚镇静可能是无痛内镜筛查的理想工具。
