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Conventional versus Analgesia-Oriented Combination Sedation on Recovery Profiles and Satisfaction after ERCP: A Randomized Trial.

Shin S, Oh TG, Chung MJ, Park JY, Park SW, Chung JB, Song SY, Cho J, Park SH, Yoo YC, Bang S - PLoS ONE (2015)

Bottom Line: Recovery profiles, satisfaction levels of the endoscopists and patients, drug requirements and complications were compared between groups.Patients of the Combination Group required significantly less propofol compared to the Conventional Group (135.0 ± 68.8 mg vs. 165.3 ± 81.7 mg, P = 0.005).Considering the significant reduction in propofol dose, the non-inferiority of recovery profiles and satisfaction scores of the endoscopists and patients, analgesia oriented combination sedation may be a more safe yet effective sedative method compared to conventional balanced propofol sedation during ERCP.

View Article: PubMed Central - PubMed

Affiliation: Department of Anesthesiology and Pain Medicine, Severance Hospital, Anesthesia and Pain Research Institute, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, 03722, Seoul, Korea.

ABSTRACT

Background: The importance of providing effective analgesia during sedation for complex endoscopic procedures has been widely recognized. However, repeated administration of opioids in order to achieve sufficient analgesia may carry the risk of delayed recovery after propofol based sedation. This study was done to compare recovery profiles and the satisfaction of the endoscopists and patients between conventional balanced propofol sedation and analgesia-oriented combination sedation for patients undergoing endoscopic retrograde cholangiopancreatography (ERCP).

Methods: Two hundred and two adult patients scheduled for ERCP were sedated by either the Conventional (initial bolus of meperidine with propofol infusion) or Combination (repeated bolus doses of fentanyl with propofol infusion) method. Recovery profiles, satisfaction levels of the endoscopists and patients, drug requirements and complications were compared between groups.

Results: Patients of the Combination Group required significantly less propofol compared to the Conventional Group (135.0 ± 68.8 mg vs. 165.3 ± 81.7 mg, P = 0.005). Modified Aldrete scores were not different between groups throughout the recovery period, and recovery times were also comparable between groups. Satisfaction scores were not different between the two groups in both the endoscopists and patients (P = 0.868 and 0.890, respectively).

Conclusions: Considering the significant reduction in propofol dose, the non-inferiority of recovery profiles and satisfaction scores of the endoscopists and patients, analgesia oriented combination sedation may be a more safe yet effective sedative method compared to conventional balanced propofol sedation during ERCP.

No MeSH data available.


CONSORT flowchart.
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pone.0138422.g001: CONSORT flowchart.

Mentions: The CONSORT flow diagram of this study is shown in Fig 1. Of the 232 patients that were assessed for eligibility, 12 patients that received propofol sedation for endoscopic ultrasound just before ERCP and another 5 patients in whom ERCP was cancelled were excluded from this study. The remaining 215 patients were randomly assigned to either the Conventional Group (n = 107) or the Combination Group (n = 108). After randomization, 7 patients in the Conventional Group and 6 patients in the Combination Group were dropped from analysis due to incomplete medical records or missing data at the time of analysis. The remaining 202 patients (100 and 102 patients of the Conventional Group and Combination Group, respectively) successfully completed the study and were included for analysis.


Conventional versus Analgesia-Oriented Combination Sedation on Recovery Profiles and Satisfaction after ERCP: A Randomized Trial.

Shin S, Oh TG, Chung MJ, Park JY, Park SW, Chung JB, Song SY, Cho J, Park SH, Yoo YC, Bang S - PLoS ONE (2015)

CONSORT flowchart.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4581832&req=5

pone.0138422.g001: CONSORT flowchart.
Mentions: The CONSORT flow diagram of this study is shown in Fig 1. Of the 232 patients that were assessed for eligibility, 12 patients that received propofol sedation for endoscopic ultrasound just before ERCP and another 5 patients in whom ERCP was cancelled were excluded from this study. The remaining 215 patients were randomly assigned to either the Conventional Group (n = 107) or the Combination Group (n = 108). After randomization, 7 patients in the Conventional Group and 6 patients in the Combination Group were dropped from analysis due to incomplete medical records or missing data at the time of analysis. The remaining 202 patients (100 and 102 patients of the Conventional Group and Combination Group, respectively) successfully completed the study and were included for analysis.

Bottom Line: Recovery profiles, satisfaction levels of the endoscopists and patients, drug requirements and complications were compared between groups.Patients of the Combination Group required significantly less propofol compared to the Conventional Group (135.0 ± 68.8 mg vs. 165.3 ± 81.7 mg, P = 0.005).Considering the significant reduction in propofol dose, the non-inferiority of recovery profiles and satisfaction scores of the endoscopists and patients, analgesia oriented combination sedation may be a more safe yet effective sedative method compared to conventional balanced propofol sedation during ERCP.

View Article: PubMed Central - PubMed

Affiliation: Department of Anesthesiology and Pain Medicine, Severance Hospital, Anesthesia and Pain Research Institute, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, 03722, Seoul, Korea.

ABSTRACT

Background: The importance of providing effective analgesia during sedation for complex endoscopic procedures has been widely recognized. However, repeated administration of opioids in order to achieve sufficient analgesia may carry the risk of delayed recovery after propofol based sedation. This study was done to compare recovery profiles and the satisfaction of the endoscopists and patients between conventional balanced propofol sedation and analgesia-oriented combination sedation for patients undergoing endoscopic retrograde cholangiopancreatography (ERCP).

Methods: Two hundred and two adult patients scheduled for ERCP were sedated by either the Conventional (initial bolus of meperidine with propofol infusion) or Combination (repeated bolus doses of fentanyl with propofol infusion) method. Recovery profiles, satisfaction levels of the endoscopists and patients, drug requirements and complications were compared between groups.

Results: Patients of the Combination Group required significantly less propofol compared to the Conventional Group (135.0 ± 68.8 mg vs. 165.3 ± 81.7 mg, P = 0.005). Modified Aldrete scores were not different between groups throughout the recovery period, and recovery times were also comparable between groups. Satisfaction scores were not different between the two groups in both the endoscopists and patients (P = 0.868 and 0.890, respectively).

Conclusions: Considering the significant reduction in propofol dose, the non-inferiority of recovery profiles and satisfaction scores of the endoscopists and patients, analgesia oriented combination sedation may be a more safe yet effective sedative method compared to conventional balanced propofol sedation during ERCP.

No MeSH data available.