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Use of deep intravenous sedation with propofol and the laryngeal mask airway during transesophageal echocardiography.

Abstract：

OBJECTIVE:To describe the use of either deep intravenous sedation with propofol or light sedation with midazolam and topical anesthesia during transesophageal echocardiography (TEE) and to report the incidence of respiratory complications and their management. DESIGN:Retrospective study from March 2000 through August 2002. SETTING:Single institution, specialized cancer center. PARTICIPANTS:All patients undergoing TEE examination in the specified time period (n = 42). MAIN RESULTS:Eight patients received light sedation and 34 patients received deep intravenous sedation with propofol. An airway event occurred in one patient in the light sedation group and in six patients in the deep sedation group. The patient in the light sedation group was managed with the use of a face-mask and a manual resuscitation bag. All airway events in the deep sedation group were managed successfully using the laryngeal mask airway (LMA). CONCLUSION:Deep sedation with intravenous propofol can provide both excellent patient comfort and optimal conditions for TEE examination, particularly in patients who may require more lengthy procedures or in whom other techniques have failed. Although the incidence of respiratory depression was higher in patients receiving deep sedation with propofol than in patients who were lightly sedated (17.6% versus 12.5%, respectively), all six patients who had respiratory depression while under deep sedation with propofol were successfully ventilated using the LMA trade mark, without the need to remove the TEE probe and without terminating the examination prematurely. In contrast, in the one patient in the light sedation group who had respiratory depression, the TEE probe had to be removed to ventilate the patient via a face mask, and the procedure was cancelled.

journal_name

J Cardiothorac Vasc Anesth

journal_title

Journal of cardiothoracic and vascular anesthesia

authors

Ferson D,Thakar D,Swafford J,Sinha A,Sapire K,Arens J

doi

10.1016/s1053-0770(03)00147-2

keywords:

subject

Has Abstract

pub_date

2003-08-01 00:00:00

pages

443-6

issue

eissn

1053-0770

issn

1532-8422

pii

S1053077003001472

journal_volume

pub_type

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Use of deep intravenous sedation with propofol and the laryngeal mask airway during transesophageal echocardiography.