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Sedation for interventional gastrointestinal endoscopic procedures: are we overlooking the pain?

Authors
 Seokyung Shin  ;  Sang Kil Lee  ;  Kyung Tae Min  ;  Hyun Ju Kim  ;  Chan Hyuk Park  ;  Young Chul Yoo 
Citation
 Surgical Endoscopy , Vol.28(1) : 100-107, 2014 
Journal Title
 Surgical Endoscopy  
ISSN
 0930-2794 
Issue Date
2014
Abstract
BACKGROUND: Although interventional gastrointestinal (GI) endoscopic procedures are known to cause greater pain and discomfort than diagnostic procedures, the efficacy of adequate pain control or the difference in pain and amount of analgesic required according to type of intervention is not well known. This study was done to investigate the safety and efficacy of combining fentanyl with propofol for interventional GI endoscopic procedures and determine whether this method is superior to propofol monosedation. METHODS: The data of 810 patients that underwent interventional GI endoscopic procedures under sedation with either propofol alone (Group P, n = 499) or propofol/fentanyl (Group PF, n = 311) at a single tertiary-care hospital between May 2012 and December 2012 were retrospectively reviewed. Rates of respiratory and cardiovascular events, propofol and fentanyl requirements, and risk factors of respiratory events of the two groups were analyzed. RESULTS: The incidence of respiratory events (P = 0.001), number of cases in which the procedure had to be interrupted for assisted mask bagging (P = 0.044), and propofol infusion rates were significantly lower in Group PF compared to Group P (P < 0.0001). The amount of fentanyl required for diagnostic procedures was significantly lower than that for interventional procedures (P < 0.001). Patients of Group PF showed a lower risk of developing respiratory events compared to Group P (OR 0.224, 95 % CI 0.069–0.724). CONCLUSIONS: Combining fentanyl with propofol seems to reduce the risk of respiratory events compared with propofol monosedation during GI endoscopic procedures by providing effective analgesia.
Full Text
http://link.springer.com/article/10.1007%2Fs00464-013-3133-y
DOI
10.1007/s00464-013-3133-y
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Anesthesiology and Pain Medicine (마취통증의학교실) > 1. Journal Papers
Yonsei Authors
김현주(Kim, Hyun Ju)
민경태(Min, Kyeong Tae) ORCID logo https://orcid.org/0000-0002-3299-4500
박찬혁(Park, Chan Hyuk)
신서경(Shin, Seokyung) ORCID logo https://orcid.org/0000-0002-2641-0070
유영철(Yoo, Young Chul) ORCID logo https://orcid.org/0000-0002-6334-7541
이상길(Lee, Sang Kil) ORCID logo https://orcid.org/0000-0002-0721-0364
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/98058
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