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| Content Provider | World Health Organization (WHO)-Global Index Medicus |
|---|---|
| Author | Yoo, Y. C. Park, C. H. Shin, S. Park, Y. Lee, S. K. Min, K. T. |
| Description | Author Affiliation: Yoo YC ( Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute.); Park CH ( Division of Gastroenterology, Department of Internal Medicine, Yonsei Institute of Gastroenterology, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul 120-752, Republic of Korea.); Shin S ( Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute.); Park Y ( Division of Gastroenterology, Department of Internal Medicine, Yonsei Institute of Gastroenterology, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul 120-752, Republic of Korea.); Lee SK ( Division of Gastroenterology, Department of Internal Medicine, Yonsei Institute of Gastroenterology, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul 120-752, Republic of Korea sklee@yuhs.ac ktmin501@yuhs.ac.); Min KT ( Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute sklee@yuhs.ac ktmin501@yuhs.ac.) |
| Abstract | BACKGROUND: Moderate to deep sedation has been recommended during endoscopic submucosal dissection (ESD). However, it is often accompanied by adverse events such as respiratory depression or aspiration pneumonia. This study investigated the respiratory complications and ESD outcomes of two sedation protocols: moderate sedation with analgesic supplementation (MSAS) and analgesia targeted light sedation (ATLS). METHODS: The clinical data of 293 patients who underwent ESD between May and December 2012 were reviewed. During the first 4 months, 155 patients were managed by moderate sedation [Modified Observer Assessment of Alertness/Sedation (MOAA/S) at 2-3] with the MSAS protocol. During the latter period, 138 patients were managed using the ATLS protocol (MOAA/S at 4-5). For both protocols, propofol and remifentanil were infused for sedation and pain control, respectively. RESULTS: The ATLS protocol required less propofol [22.9 (sd 17.3) vs 88.1 (44.0) µg kg(-1) min(-1), P<0.001] and more remifentanil [6.8 (sd 3.1) vs 4.9 (3.0) µg kg(-1) hr(-1), P<0.001] than the MSAS protocol. The desaturation events during the procedure occurred significantly less often (2.2 vs 12.9%, P=0.001) and recovery was significantly faster [19.7 (sd 4.8) vs 27.9 (16.0) min, P<0.001] with the ATLS protocol than with the MSAS protocol. The incidence of aspiration pneumonia with the ATLS protocol was 1.4% compared with 5.2% with the MSAS protocol (P=0.109). There were no differences in outcomes and complications of ESD. CONCLUSION: The ATLS protocol reduced the incidence of desaturation events without affecting ESD performance compared with the MSAS protocol. There was also a trend towards a low incidence of aspiration pneumonia with the ATLS protocol. |
| File Format | HTM / HTML |
| ISSN | 00070912 |
| e-ISSN | 14716771 |
| Journal | British Journal of Anaesthesia |
| Issue Number | 1 |
| Volume Number | 115 |
| Language | English |
| Publisher | Oxford University Press |
| Publisher Date | 2015-07-01 |
| Publisher Place | Great Britain (UK) |
| Access Restriction | Open |
| Subject Keyword | Discipline Anesthesiology Analgesia Anesthesia Conscious Sedation Gastric Mucosa Surgery Anesthesia Recovery Period Endoscopy Hypnotics And Sedatives Piperidines Pneumonia, Aspiration Epidemiology Propofol Retrospective Studies Comparative Study |
| Content Type | Text |
| Resource Type | Article |
| Subject | Anesthesiology and Pain Medicine |
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