Szederjesi Janos, Săplăcan Irina, Lazăr Alexandra, Keresztes Matild, Muller-Șerban Georgiana-Mihaela, Szasz Jozsef Attila, Grigorescu Bianca Liana
Department of Intensive Care, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Târgu-Mureș, 540139 Târgu Mureș, Romania.
2nd Clinic of Neurology, Târgu Mures, County Emergency Clinical Hospital, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Târgu-Mureș, 540139 Târgu Mureș, Romania.
Life (Basel). 2025 Mar 18;15(3):492. doi: 10.3390/life15030492.
The management of sedation during percutaneous endoscopic gastrojejunostomy (PEG-J) placement in patients with advanced Parkinson's disease (PD) is challenging due to the complex interactions between PD treatment, anesthetic agents, and the disease's motor and non-motor symptoms. This study evaluates the effectiveness and safety of a target-controlled infusion (TCI) propofol protocol in the context of PEG-J placement in advanced PD patients.
This prospective study included 169 patients diagnosed with advanced Parkinson's disease (Hoehn and Yahr stages 4 and 5) who underwent PEG-J placement at Târgu Mureș County Emergency Clinical Hospital, Romania. Sedation was induced and maintained using TCI propofol, with additional benzodiazepines and short-acting opioids, while muscle relaxants were not used. Procedural success rates and adverse outcomes were assessed for 30 days post-procedure.
The sedation protocol demonstrated a high procedural success rate. No deaths were reported within 30 days post-procedure.
This study highlights the feasibility and clinical applicability of a TCI propofol protocol for PEG-J placement in patients with advanced PD (stages 4 and 5). While no deaths were recorded within the 30-day follow-up, the sample size is insufficient to draw definitive conclusions regarding long-term safety.
在晚期帕金森病（PD）患者行经皮内镜下胃空肠造口术（PEG-J）时，由于PD治疗、麻醉药物以及该疾病的运动和非运动症状之间存在复杂的相互作用，镇静管理具有挑战性。本研究评估了在晚期PD患者PEG-J置入过程中目标控制输注（TCI）丙泊酚方案的有效性和安全性。
这项前瞻性研究纳入了169例被诊断为晚期帕金森病（ Hoehn和Yahr分期为4期和5期）的患者，他们在罗马尼亚特尔古穆列什县急诊临床医院接受了PEG-J置入术。使用TCI丙泊酚诱导并维持镇静，同时使用额外的苯二氮䓬类药物和短效阿片类药物，未使用肌肉松弛剂。对术后30天的手术成功率和不良结局进行评估。
镇静方案显示出较高的手术成功率。术后30天内未报告死亡病例。
本研究强调了TCI丙泊酚方案在晚期PD（4期和5期）患者PEG-J置入术中的可行性和临床适用性。虽然在30天随访期内未记录到死亡病例，但样本量不足以就长期安全性得出明确结论。
