Comparison of three sedation models for same-day painless bidirectional endoscopy: A multicenter randomized controlled trial.
J Gastroenterol Hepatol
; 37(8): 1603-1609, 2022 Aug.
Article
em En
| MEDLINE
| ID: mdl-35618650
ABSTRACT
BACKGROUND AND AIM:
We investigated the most beneficial propofol sedation model for same-day painless bidirectional endoscopy (BDE).METHODS:
Asymptomatic participants scheduled for same-day painless BDE examination from October 2020 to September 2021 were randomized to three groups sedated esophagogastroduodenoscopy followed by unsedated colonoscopy (Group A); sedated esophagogastroduodenoscopy followed by sedated colonoscopy (Group B); and sedated esophagogastroduodenoscopy followed by sedated insertion colonoscopy (Group C). Patient discomfort, colonoscopy performance, doses of propofol, cardiovascular stress, anesthesia resuscitation, and sedation-related adverse events were evaluated.RESULTS:
A total of 3200 participants were analyzed. Baseline demographics, patient discomfort, cecal intubation rate, adenoma detection rate and sedation-related adverse events were similar in the three groups. Propofol dose was the lowest in Group A (137.65 ± 36.865 mg) compared with Group B (177.71 ± 40.112 mg, P < 0.05) and Group C (161.63 ± 31.789 mg, P < 0.05). Decline in vital signs was most obvious in Group B during the procedure (P < 0.05). Recovery time was the shortest in Group A (5.01 ± 1.404 min) compared with Group B (9.51 ± 2.870 min, P < 0.05) and Group C (5.83 ± 2.594 min, P < 0.05); discharge time was the shortest in Group A (3.53 ± 1.685 min) compared with Group B (11.29 ± 5.172 min, P < 0.05) and Group C (6.47 ± 2.338 min, P < 0.05). Adenomas per positive patient of Group A (2.29 ± 1.055) and Group C (2.28 ± 0.931) were more than that in Group B (2.11 ± 0.946, P < 0.05).CONCLUSIONS:
Sedated esophagogastroduodenoscopy followed by unsedated colonoscopy is the superior model for same-day painless BDE with the benefits of satisfactory patient comfort, reduced sedation dose, less cardiovascular stress, faster recovery, shorter discharge time and high colonoscopy quality.Palavras-chave
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Base de dados:
MEDLINE
Assunto principal:
Propofol
/
Anestesia
Idioma:
En
Ano de publicação:
2022
Tipo de documento:
Article