Abstract:
BACKGROUND:There is increasing interest in the use of propofol, an ultrashort-acting hypnotic agent, for sedation during endoscopic examinations. A protocol was developed for administration of propofol, combined with small doses of midazolam and meperidine, for endoscopic sedation under the direction of a gastroenterologist. Initial experience with using this protocol is described. METHODS:A total of 819 consecutive endoscopic examinations under sedation with propofol, midazolam, and meperidine (or fentanyl), in adherence with the sedation protocol, were reviewed retrospectively. RESULTS:There were 638 colonoscopies and 181 EGDs; 89% of patients were classified as American Society of Anesthesiologists (ASA) class I or II. Mean dosages of medications were: propofol 63 (33.5) mg, meperidine 48 (7.2) mg, and midazolam 1 (0.12) mg. The dose of propofol was inversely correlated with age and ASA class, and positively correlated with patient weight and duration of examination. Hypotension (>20 mm Hg decline in either systolic or diastolic blood pressure) developed in 218 (27%) patients, and hypoxemia (oxygen saturation <90%) developed in 75 (9%). All episodes of hypotension and hypoxemia were transient, and no patient required administration of a pharmacologic antagonist or assisted ventilation. The average time for recovery after colonoscopy and after EGD was, respectively, 25 minutes and 28 minutes. All EGDs and 98% of colonoscopies were completed successfully. CONCLUSIONS:On the basis of this initial experience, it is believed that propofol, potentiated by small doses of midazolam and meperidine, can be safely and effectively administered under the direction of a gastroenterologist. Additional research will be necessary to determine whether propofol is superior to the current methods of sedation.
journal_name
Gastrointest Endoscjournal_title
Gastrointestinal endoscopyauthors
Cohen LB,Dubovsky AN,Aisenberg J,Miller KMdoi
10.1016/s0016-5107(03)02010-8keywords:
subject
Has Abstractpub_date
2003-11-01 00:00:00pages
725-32issue
5eissn
0016-5107issn
1097-6779pii
S0016-5107(03)02010-8journal_volume
58pub_type
杂志文章abstract:BACKGROUND:Quality endoscopy reporting is essential when community endoscopists perform colonoscopies for veterans who cannot be scheduled at a Veterans Administration (VA) facility. OBJECTIVE:To examine the quality of colonoscopy reports received from community practices and to determine factors associated with more ...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2010.03.002
更新日期:2010-08-01 00:00:00
abstract:BACKGROUND AND AIMS:The risk of colorectal cancer (CRC) in various chronic liver diseases compared with the general population remains unclear. We performed a systematic review and meta-analysis to assess the risk of CRC in patients with chronic liver diseases before and after liver transplantation. METHODS:Electronic...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章,meta分析,评审
doi:10.1016/j.gie.2016.12.009
更新日期:2017-07-01 00:00:00
abstract:BACKGROUND:The ability to access the abdominal cavity though a direct (modified-PEG type) gastric incision to perform natural orifice transluminal endoscopic surgery (NOTES) has been demonstrated in the literature. However, the optimal technique to access the abdomen remains unknown. OBJECTIVE:The aim of this study wa...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2007.09.023
更新日期:2008-04-01 00:00:00
abstract:BACKGROUND:Autoimmune pancreatitis has been designated as sclerosing pancreatocholangitis, because this disease shows a high prevalence of bile-duct lesions. We present herein the clinical characteristics of unusual cases that show dominant bile-duct lesions and mimicking infiltrating hilar cholangiocarcinomas. METHOD...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/s0016-5107(05)00561-4
更新日期:2005-07-01 00:00:00
abstract:BACKGROUND:Hands-on endoscopy workshops are popular and valuable sources for the continuing medical education of endoscopists. Concerns, however, exist regarding clinical outcomes of procedures performed during hands-on training of ERCP. OBJECTIVE:We compared the success rates and complications between patients in the...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章,多中心研究
doi:10.1016/j.gie.2008.05.029
更新日期:2009-02-01 00:00:00
abstract:BACKGROUND:Pentoxifylline can ameliorate pancreatitis in animal models because of its anti-tumor necrosis factor properties. OBJECTIVE:Our purpose was to study the safety and efficacy of pentoxifylline in the prevention of post-ERCP pancreatitis. DESIGN:Patients due to undergo ERCP for various indications were random...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.gie.2007.03.1045
更新日期:2007-09-01 00:00:00
abstract:BACKGROUND:Thermal therapy is the cornerstone of endoscopic treatment of bleeding mucosal lesions of the GI tract. However, there is a 20% failure rate and contact devices may be cumbersome in the treatment of large bleeding areas. A pilot study was conducted to evaluate the safety and efficacy of endoscopic cryotherap...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1067/mge.2003.115
更新日期:2003-03-01 00:00:00
abstract:BACKGROUND:Endoscopic ultrasonographically guided fine-needle aspiration (EUS-FNA) is a safe and accurate method for obtaining diagnostic material from lesions within and immediately adjacent to the upper GI tract. OBJECTIVE:To determine whether EUS Trucut biopsy (EUS-TCB) (Quickcore, Wilson-Cook, Winstom Salem, NC) c...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2006.02.056
更新日期:2006-10-01 00:00:00
abstract:BACKGROUND:Insertion of self-expandable metallic stents (SEMS) can provide rapid relief of malignant colorectal obstruction and can be used as a palliative treatment or as a bridge to surgery. A SEMS can be classified as an uncovered or covered stent. Both types of stents have their own merits and demerits. OBJECTIVE:...
journal_title:Gastrointestinal endoscopy
pub_type: 临床试验,杂志文章
doi:10.1016/j.gie.2007.02.064
更新日期:2007-11-01 00:00:00
abstract:BACKGROUND:Recent studies highlight the role of duodenal bulb biopsy in the diagnosis of celiac disease. OBJECTIVE:To determine whether a targeted duodenal bulb biopsy in addition to distal duodenal biopsies is the optimal strategy to identify villous atrophy. DESIGN:Prospective cohort study. SETTING:Tertiary-care r...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2012.02.025
更新日期:2012-06-01 00:00:00
abstract:BACKGROUND:Comprehensive, population-based data on ERCP use over the last 30 years in North America are lacking. OBJECTIVE:To establish crude and age-adjusted population-based rates of ERCP, evaluate for changing indications for ERCP, and evaluate for interactions between cholecystectomy technique and ERCP use from 19...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2013.08.028
更新日期:2014-04-01 00:00:00
abstract:BACKGROUND:Ventral hernia repair is currently performed via open surgery or laparoscopic approach. OBJECTIVE:To develop an alternative ventral hernia repair technique. SETTING:Acute and survival experiments on twelve 50-kg pigs. DESIGN AND INTERVENTIONS:An endoscope was introduced transgastrically into the peritonea...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2008.04.014
更新日期:2009-01-01 00:00:00
abstract:BACKGROUND:Appropriateness of indications is essential to the rational utilization of resources. The aim of this study was to evaluate the appropriate use of colonoscopy in an open access system and to assess whether the American Society for Gastrointestinal Endoscopy (ASGE) guidelines are useful in clinical practice. ...
journal_title:Gastrointestinal endoscopy
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1067/mge.2000.106683
更新日期:2000-07-01 00:00:00
abstract:BACKGROUND:There are few data about the performance variability among endoscopists participating to nationwide or regionwide colorectal cancer screening programs. OBJECTIVE:To assess the variability of neoplasia detection rates among endoscopists participating in a regional colorectal cancer screening program based on...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2009.08.032
更新日期:2010-02-01 00:00:00
abstract:BACKGROUND:Per current guidelines, patients with a first-degree relative (FDR) with colorectal cancer (CRC) should get screened at least at age 40. Data about the prevalence of adenomas and advanced adenomas (AAs) in these patients are lacking. OBJECTIVE:To examine the prevalence of adenomas and AAs in 40- to 49-year-...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2011.02.010
更新日期:2011-07-01 00:00:00
abstract:BACKGROUND:The long-term efficacy of sequential insertion of multiple plastic stents for benign biliary strictures is poorly defined. The aims of this study were to evaluate the long-term outcome (bile duct patency, complications) of this therapy and to identify predictors of a good outcome. METHODS:Retrospective revi...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1067/mge.2002.122955
更新日期:2002-05-01 00:00:00
abstract:BACKGROUND:Endoscopic papillary balloon dilation (EPBD) has a lower risk of hemorrhage than sphincterotomy and is easier to perform in altered/difficult anatomy. However, the sphincter of Oddi (SO) is only stretched but not cut after EPBD. Therefore, the biliary orifice is less opened, and failed stone extraction with ...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1016/j.gie.2010.07.009
更新日期:2010-12-01 00:00:00
abstract:BACKGROUND:Direct percutaneous endoscopic jejunostomy (DPEJ) placement succeeds in 72% to 86% of attempts. Failure is most often because of inadequate transillumination or gastroduodenal obstruction. Even in failed cases, patients are exposed to the risks of anesthesia, exploratory percutaneous needle punctures, and th...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2005.10.035
更新日期:2006-03-01 00:00:00
abstract:BACKGROUND AND AIMS:Capsule endoscopy (CE) can detect lesions outside the scope of ileocolonoscopy in postoperative patients with Crohn's disease (CD). However, the impact of such findings on patient outcomes remains unknown. This study is intended to evaluate the impact of CE findings on clinical management and outcom...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2018.01.017
更新日期:2018-06-01 00:00:00
abstract:BACKGROUND:Biliary complications are the second leading cause of morbidity and mortality in orthotopic liver transplant (OLT) recipients. Endoscopic retrograde cholangiography (ERC) is considered the diagnostic criterion standard for post-orthotopic liver transplantation biliary obstruction, but incurs significant risk...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章,meta分析,评审
doi:10.1016/j.gie.2010.12.014
更新日期:2011-05-01 00:00:00
abstract:BACKGROUND:Diagnostic natural-orifice transluminal endoscopic surgery (NOTES) peritoneoscopy can easily be performed with standard endoscopic equipment in animal studies. The efficacy and optimal transgastric site for NOTES access in humans, however, has not been determined. OBJECTIVE:To characterize the efficacy of v...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2010.03.1070
更新日期:2010-08-01 00:00:00
abstract::Overgrowth of an esophageal prosthesis by cancer is a late complication of insertion which presents a difficult management problem. We have treated 14 such patients; 9 had Celestin tubes and 5 Atkinson tubes in situ for a median of 7 months. The median patient age was 75 years; 3 had squamous cell carcinomas and 11 ad...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/s0016-5107(92)70383-6
更新日期:1992-03-01 00:00:00
abstract::Epinephrine injection is an effective, simple, and economical method of endoscopic hemostasis for bleeding peptic ulcers. We measured catecholamine levels in 18 patients with actively bleeding ulcers (8 gastric ulcers and 10 duodenal ulcers) treated by endoscopic injection. Injection of epinephrine (1:10,000 IU) was g...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/s0016-5107(93)70004-8
更新日期:1993-01-01 00:00:00
abstract:BACKGROUND:Colonoscopy is the preferred screening method for colorectal cancer. However, it has a substantial miss rate for colon polyps, and several techniques have been attempted to improve this limitation. Narrow-band imaging (NBI) is a novel technology that enhances the visualization of surface mucosal and vascular...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2007.07.036
更新日期:2008-02-01 00:00:00
abstract:BACKGROUND AND AIMS:Lumen-apposing metal stents (LAMSs) are used to perform necrosectomy in walled-off necrosis (WON). Although necrosectomy is not required for pancreatic pseudocyst (PP), an increasing number of PPs are also being drained with LAMSs in view of their ease of deployment. The aim of the present study was...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2017.11.033
更新日期:2018-05-01 00:00:00
abstract:BACKGROUND AND AIMS:A structured comprehensive curriculum (SCC) that uses simulation-based training (SBT) can improve clinical colonoscopy performance. This curriculum may be enhanced through the application of progressive learning, a training strategy centered on incrementally challenging learners. We aimed to determi...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.gie.2017.03.1529
更新日期:2017-11-01 00:00:00
abstract:BACKGROUND:Despite advances in diagnostic imaging techniques, the differentiation between pancreatic cancer and focal pancreatitis remains difficult. This study evaluated the effectiveness of EUS-guided FNA in the differential diagnosis between pancreatic cancer and focal pancreatitis, with particular reference to dete...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/s0016-5107(04)02224-2
更新日期:2005-01-01 00:00:00
abstract::Disposable plastic biopsy forceps were compared prospectively to reusable stainless steel forceps. Thirty consecutive patients underwent a total of 249 biopsies, 124 with the disposable forceps, and 125 with reusable forceps. Biopsy locations included the esophagus, stomach, small intestine, colon, and common bile duc...
journal_title:Gastrointestinal endoscopy
pub_type: 临床试验,杂志文章
doi:10.1016/s0016-5107(90)71069-3
更新日期:1990-07-01 00:00:00
abstract::Thirty patients with upper gastrointestinal bleeding due to a Mallory-Weiss tear were diagnosed by endoscopy. Seventeen patients had stopped bleeding spontaneously, and 13 were actively bleeding when examined. Ten of these 13 were successfully electrocoagulated with cessation of bleeding without morbidity or mortality...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/s0016-5107(80)73301-1
更新日期:1980-11-01 00:00:00
abstract:BACKGROUND:Endoscopic resection of large colorectal lesions is associated with high complication rates. OBJECTIVE:To evaluate the effect of prophylactic clip closure of polypectomy sites after resection of large (≥2 cm) sessile and flat colorectal lesions. DESIGN:Retrospective study. SETTING:Tertiary referral center...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2012.10.024
更新日期:2013-03-01 00:00:00