Villanueva Renzo Inca, Montero Cynthia Bazán, Bulnes-Montánchez María Estela, Alva Lary Salazar, Carrillo José Salvador, Zevallos Alejandra, Salazar Fernando
Escuela Profesional de Medicina Humana, Universidad Privada San Juan Bautista, Lima, Peru.
Departamento de Gastroenterología, Clínica Ricardo Palma, Lima, Peru.
BMC Anesthesiol. 2025 May 6;25(1):228. doi: 10.1186/s12871-025-03012-2.
Endoscopic procedures are essential for diagnosing and managing gastrointestinal conditions, often requiring sedation for patient comfort. Propofol is a common choice for outpatient sedation due to its rapid onset and predictable recovery time. Although propofol has an established safety profile, adverse drug reactions (ADRs) can still occur. This study investigated the prevalence and risk factors associated with ADRs related to nurse-administered propofol sedation during outpatient endoscopic procedures at a private hospital in Peru.
We conducted a retrospective study. The clinical records of 919 Peruvian patients who underwent endoscopic interventions under propofol sedation were reviewed. This study included patients between the ages of 18 and 69 years who had American Society of Anesthesiologists (ASA) physical status classification scores of I-III and who were hemodynamically stable with an oxygen saturation (SO2) > 90% before the procedure. Sedation was nurse-administered using standardized protocols. ADR data, including severity and causality assessment data, were collected. Data were collected and analyzed by SPSS, Inc., and the statistical significance was calculated at the p < 0.05 level.
A total of 693 patients were included in the study, 30.9% of whom experienced at least one ADR, predominantly cardiovascular or respiratory events such as hypotension and hypoxia, with causality scores classified as probable or definitive. Among the ADRs, 35.8% (n = 87) were moderately severe, and 64.2% (n = 143) were mildly severe. There were no reports of any serious adverse events. An ASA class III status (p = 0.048, PR adjusted (PRa) = 1.73, 95% CI: 1.01-2.99) and a procedure time of more than 20 min (p < 0.0001, PRa = 2.05, 95% CI: 1.53-2.73) were significant risk factors for ADR occurrence. Patients with ADRs had longer recovery times than did those without ADRs (22 min ± 22.5 vs. 14 min ± 8, respectively; p < 0.001).
In our work, moderate propofol sedation administered by trained nursing staff to outpatients undergoing interventional endoscopic procedures was generally safe but not free from risks. Vital parameters should be monitored regularly during long-term interventions and when patients are classified as ASA III.
内镜检查程序对于胃肠道疾病的诊断和治疗至关重要，通常需要给予镇静剂以确保患者舒适。丙泊酚因其起效迅速且恢复时间可预测，是门诊镇静的常用选择。尽管丙泊酚具有既定的安全概况，但仍可能发生药物不良反应（ADR）。本研究调查了秘鲁一家私立医院门诊内镜检查过程中与护士给予丙泊酚镇静相关的ADR的发生率及危险因素。
我们进行了一项回顾性研究。回顾了919例接受丙泊酚镇静下内镜干预的秘鲁患者的临床记录。本研究纳入了年龄在18至69岁之间、美国麻醉医师协会（ASA）身体状况分类评分为I - III级且在手术前血流动力学稳定、氧饱和度（SO2）> 90%的患者。镇静由护士按照标准化方案实施。收集了包括严重程度和因果关系评估数据在内的ADR数据。数据由SPSS公司收集和分析，并在p < 0.05水平计算统计学显著性。
本研究共纳入693例患者，其中30.9%至少经历了一次ADR，主要为心血管或呼吸事件，如低血压和低氧血症，因果关系评分分类为可能或肯定。在ADR中，35.8%（n = 87）为中度严重，64.2%（n = 143）为轻度严重。没有任何严重不良事件的报告。ASA III级状态（p = 0.048，调整后PR（PRa）= 1.73，95% CI：1.01 - 2.99）和手术时间超过20分钟（p < 0.0001，PRa = 2.05，95% CI：1.53 - 2.73）是ADR发生的显著危险因素。发生ADR的患者恢复时间比未发生ADR的患者更长（分别为22分钟±22.5分钟和14分钟±8分钟；p < 0.001）。
在我们的研究中，由训练有素的护理人员对接受介入性内镜检查的门诊患者进行中度丙泊酚镇静总体上是安全的，但并非没有风险。在长期干预期间以及患者被分类为ASA III级时，应定期监测生命体征参数。
