Risk Factors and Outcomes of Reversal Agent Use in Moderate Sedation During Endoscopy and Colonoscopy.

Abstract:

BACKGROUND:Moderate sedation has been standard for noninvasive gastrointestinal procedures for decades yet there are limited data on reversal agent use and outcomes associated with need for reversal of sedation. AIM:To determine prevalence and clinical significance of reversal agent use during endoscopies and colonoscopies. METHODS:Individuals with adverse events requiring naloxone and/or flumazenil during endoscopy or colonoscopy from 2008 to 2013 were identified. A control group was obtained by random selection of patients matched by procedure type and date. Prevalence of reversal agent use and statistical comparison of patient demographics and risk factors against controls were determined. RESULTS:Prevalence of reversal agent use was 0.03% [95% confidence interval (CI), 0.02-0.04]. Events triggering reversal use were oxygen desaturation (64.4%), respiration changes (24.4%), hypotension (8.9%), and bradycardia (6.7%). Two patients required escalation of care and the majority of patients were stabilized and discharged home. Compared with the control group, the reversal group was older (61±1.8 vs. 55±1.6, P=0.01), mostly female (82% vs. 50%, P<0.01), and had lower body mass index (24±0.8 vs. 27±0.7, P=0.03) but received similar dosages of sedation. When adjusted for age, race, sex, and body mass index, the odds of reversal agent patients having a higher ASA score than controls was 4.7 (95% CI, 1.7-13.1), and the odds of having a higher Mallampati score than controls was 5.0 (95% CI, 2.1-11.7) with P<0.01. CONCLUSIONS:Prevalence of reversal agent use during moderate sedation is low and outcomes are generally good. Several clinically relevant risk factors for reversal agent use were found suggesting that certain groups may benefit from closer monitoring.

journal_name

J Clin Gastroenterol

authors

Hung A,Marshall J,Barnett S,Falchuk ZM,Sawhney M,Leffler DA

doi

10.1097/MCG.0000000000000291

subject

Has Abstract

pub_date

2016-03-01 00:00:00

pages

e25-9

issue

3

eissn

0192-0790

issn

1539-2031

journal_volume

50

pub_type

杂志文章
  • Clinical applications of magnetic resonance cholangiopancreatography.

    abstract::Magnetic resonance cholangiopancreatography (MRCP) is a novel imaging technique used for noninvasive work-up of patients with pancreaticobiliary disease. Magnetic resonance cholangiopancreatography is useful in the evaluation of a host of pancreaticobiliary disorders, such as congenital disorders, calculus disease, bi...

    journal_title:Journal of clinical gastroenterology

    pub_type: 杂志文章,评审

    doi:10.1097/00004836-200111000-00004

    authors: Prasad SR,Sahani D,Saini S

    更新日期:2001-11-01 00:00:00

  • Safety of Propofol Used as a Rescue Agent During Colonoscopy.

    abstract:GOAL:The goal of this study was to evaluate the safety of propofol when used by gastroenterologists in patients who have an inadequate response to standard sedation (narcotics and benzodiazepines). BACKGROUND:Many patients fail to achieve adequate sedation from narcotics and benzodiazepines during colonoscopy. The adm...

    journal_title:Journal of clinical gastroenterology

    pub_type: 杂志文章

    doi:10.1097/MCG.0000000000000445

    authors: Okeke FC,Shaw S,Hunt KK,Korsten MA,Rosman AS

    更新日期:2016-09-01 00:00:00

  • Therapy of NAFLD: insulin sensitizing agents.

    abstract::Insulin resistance is an integral part of the underlying pathophysiology in most patients with nonalcoholic fatty liver disease (NAFLD). Insulin-sensitizing agents are therefore likely to be of key importance in the treatment of this disorder, especially in the histologically more severe form known as nonalcoholic ste...

    journal_title:Journal of clinical gastroenterology

    pub_type: 杂志文章,评审

    doi:10.1097/01.mcg.0000168647.71411.48

    authors: Caldwell SH,Argo CK,Al-Osaimi AM

    更新日期:2006-03-01 00:00:00

  • Small-volume gallbladders and decreased motility in patients with achalasia.

    abstract:AIM/BACKGROUND:Achalasia may be associated with extraesophageal dysmotility. However, this relation is still poorly understood. In the present study, we used noninvasive real-time ultrasonography to examine the motility function of the gallbladder in the patients with achalasia. MATERIALS AND METHODS:Thirty-three acha...

    journal_title:Journal of clinical gastroenterology

    pub_type: 杂志文章

    doi:10.1097/01.mcg.0000225682.52712.f7

    authors: Alagozlu H,Unal S,Karakan T,Cindoruk M,Ergun M

    更新日期:2008-02-01 00:00:00

  • Helicobacter pylori infection rate decreases in symptomatic children: a retrospective analysis of 13 years (1993-2005) from a gastroenterology clinic in West Virginia.

    abstract:BACKGROUND:The rate of Helicobacter pylori is decreasing in the developed countries, but few long-term studies are available from the United States. We retrospectively assessed the annual H. pylori infection rate in symptomatic children seen in our clinic over a 13-year study period. STUDY:A retrospective analysis of ...

    journal_title:Journal of clinical gastroenterology

    pub_type: 杂志文章

    doi:10.1097/MCG.0b013e318157e4e7

    authors: Elitsur Y,Dementieva Y,Rewalt M,Lawrence Z

    更新日期:2009-02-01 00:00:00

  • Acute renal dysfunction in salmonella gastroenteritis.

    abstract:GOALS:To determine the incidence of renal function deterioration in adult patients with Salmonella infection. BACKGROUND:Renal impairment has been described during severe Salmonella infection and is mainly due to shock, dehydration, or rhabdomyolysis. However, it is unclear whether less severe Salmonella infection als...

    journal_title:Journal of clinical gastroenterology

    pub_type: 杂志文章

    doi:10.1097/01.mcg.0000212620.20079.34

    authors: Janssen van Doorn K,Pierard D,Spapen H

    更新日期:2006-11-01 00:00:00

  • Quality of Sleep and Coexistent Psychopathology Have Significant Impact on Fatigue Burden in Patients With Inflammatory Bowel Disease.

    abstract:BACKGROUND:Fatigue is common in inflammatory bowel disease (IBD) patients and is associated with factors such as psychopathology, sleep quality, and disease activity. GOAL:To investigate the combined role of all the above factors in the burden of fatigue among IBD patients. STUDY:We conducted an observational study o...

    journal_title:Journal of clinical gastroenterology

    pub_type: 杂志文章

    doi:10.1097/MCG.0000000000000729

    authors: Hashash JG,Ramos-Rivers C,Youk A,Chiu WK,Duff K,Regueiro M,Binion DG,Koutroubakis I,Vachon A,Benhayon D,Dunn MA,Szigethy EM

    更新日期:2018-05-01 00:00:00

  • Psychotropic agents in irritable bowel syndrome.

    abstract::The use of antidepressants to treat patients with irritable bowel syndrome (IBS) has been extended in recent years because of their possible neuromodulatory and analgesic effects, generally in doses that do not have antidepressant effects. There seems to be sufficient evidence to support the recommendation that psycho...

    journal_title:Journal of clinical gastroenterology

    pub_type: 杂志文章,评审

    doi:10.1097/00004836-200207001-00010

    authors: Wald A

    更新日期:2002-07-01 00:00:00

  • Accuracy of endoscopic ultrasonography and magnetic resonance cholangiopancreatography for the diagnosis of chronic pancreatitis: a prospective comparison study.

    abstract:BACKGROUND:The diagnosis of chronic pancreatitis (CP) remains challenging. Endoscopic ultrasound (EUS) and magnetic resonance cholangiopancreatography (MRCP) have been proposed as highly accurate diagnostic modalities. Although endoscopic retrograde cholangiopancreatography (ERCP) has been previously used as a gold sta...

    journal_title:Journal of clinical gastroenterology

    pub_type: 杂志文章

    doi:10.1097/MCG.0b013e31802dfde6

    authors: Pungpapong S,Wallace MB,Woodward TA,Noh KW,Raimondo M

    更新日期:2007-01-01 00:00:00

  • Association of helicobacter pylori dupA with the failure of primary eradication.

    abstract:GOALS:To determine whether the presence of dupA Helicobacter pylori (H. pylori) influences the cure rate of primary eradication therapy. BACKGROUND:Several virulence factors of H. pylori have been reported to affect the efficacy of the eradication rate. However, no study has investigated whether the presence of dupA a...

    journal_title:Journal of clinical gastroenterology

    pub_type: 杂志文章

    doi:10.1097/MCG.0b013e318243201c

    authors: Shiota S,Nguyen LT,Murakami K,Kuroda A,Mizukami K,Okimoto T,Kodama M,Fujioka T,Yamaoka Y

    更新日期:2012-04-01 00:00:00

  • Penetrating duodenal ulcer from hepatic artery chemotherapy infusion catheter. Successful conservative medical management.

    abstract::A 45-year-old woman receiving continuous infusions of 5-fluoro-2'-deoxy-uridine into the hepatic artery through a surgically implanted intraarterial catheter for hepatic metastases from adenocarcinoma of the colon, developed acute epigastric pain and anemia. Endoscopy demonstrated a duodenal ulcer with a portion of th...

    journal_title:Journal of clinical gastroenterology

    pub_type: 杂志文章

    doi:10.1097/00004836-198808000-00016

    authors: Hutchins LF,Webb RT,Ortego TJ,Lang NP,Navab F

    更新日期:1988-08-01 00:00:00

  • Helicobacter pylori infection and related gastrointestinal diseases.

    abstract::Helicobacter pylori has been implicated in the pathogenesis of a number of digestive tract disorders, such as chronic active gastritis, peptic ulceration, gastric cancer, and mucosa-associated lymphoid tissue lymphoma. Disease outcome is dependent on many factors, including bacterial genotype, host physiology and gene...

    journal_title:Journal of clinical gastroenterology

    pub_type: 杂志文章,评审

    doi:10.1097/MCG.0b013e318030e3c3

    authors: Makola D,Peura DA,Crowe SE

    更新日期:2007-07-01 00:00:00

  • Normal thiopurine methyltransferase levels do not eliminate 6-mercaptopurine or azathioprine toxicity in children with inflammatory bowel disease.

    abstract::6-mercaptopurine (6-MP) and azathioprine (AZA) are used to treat inflammatory bowel disease (IBD). Side effects include infection, leukopenia, hepatitis, and pancreatitis. The level of thiopurine methyltransferase (TPMT), which metabolizes 6-MP to 6-methylmercaptopurine, may reflect the risk of side effects. We sought...

    journal_title:Journal of clinical gastroenterology

    pub_type: 杂志文章

    doi:10.1097/00004836-200006000-00011

    authors: Kader HA,Wenner WJ Jr,Telega GW,Maller ES,Baldassano RN

    更新日期:2000-06-01 00:00:00

  • In-practice predictors of response to proton pump inhibitor therapy in primary care patients with dyspepsia in an Asian population.

    abstract:BACKGROUND:Data on Asian patients who present to primary care physicians with dyspepsia are limited. AIM:To determine predictors of response to a trial of proton pump inhibitor therapy. METHOD:One hundred ninety patients presenting to their general practitioners with dyspeptic symptoms but without alarm symptoms, und...

    journal_title:Journal of clinical gastroenterology

    pub_type: 杂志文章

    doi:10.1097/01.mcg.0000225620.02094.c3

    authors: Gwee KA,Hwang JE,Ho KY,Yeoh KG,Lum CF,Ang PK

    更新日期:2008-02-01 00:00:00

  • Oral manifestations of Crohn's disease. An analysis of 79 cases.

    abstract::We report four new cases of oral manifestation in Crohn's disease (CD) and evaluate 75 reported cases for morphology and site of oral and intestinal manifestations of CD, clinical manifestation, and treatment. Oral CD was the presenting symptom in 43 of 72 (60%) patients and relapsed in 34 of 60 (57%). Median age at p...

    journal_title:Journal of clinical gastroenterology

    pub_type: 杂志文章,评审

    doi:10.1097/00004836-199102000-00008

    authors: Plauth M,Jenss H,Meyle J

    更新日期:1991-02-01 00:00:00

  • Nonspecific ulcerative colitis as a sequel to amebic dysentery.

    abstract::In two patients, treatment of amebic dysentery was followed (despite the disappearance of the infecting organism) by an illness with the clinical, pathological, and radiological characteristics of nonspecific ulcerative colitis. Their case histories indicate that in addition to persistent or recurrent amebic infection...

    journal_title:Journal of clinical gastroenterology

    pub_type: 杂志文章

    doi:10.1097/00004836-198306000-00004

    authors: Rampton DS,Salmon PR,Clark CG

    更新日期:1983-06-01 00:00:00

  • Effect of acute mucosal exposure to Lactobacillus rhamnosus GG on human colonic smooth muscle cells.

    abstract:AIM:To define whether human colonic mucosa exposure to Lactobacillus rhamnosus GG (LGG), American Type Culture Collection (ATCC) 53103, may influence intestinal muscle cell contractility. METHODS:Human colon specimens were obtained from disease-free margins of resected segments for cancer. The mucosa and submucosa, af...

    journal_title:Journal of clinical gastroenterology

    pub_type: 杂志文章

    doi:10.1097/MCG.0b013e31817e1cac

    authors: Guarino MP,Altomare A,Stasi E,Marignani M,Severi C,Alloni R,Dicuonzo G,Morelli L,Coppola R,Cicala M

    更新日期:2008-09-01 00:00:00

  • Modified barium swallow does not affect how often PEGs are placed after stroke.

    abstract::Dysphagia frequently follows stroke, but often resolves quickly. Percutaneous endoscopic gastrostomy (PEG) or other feeding tubes are placed to improve nutrition and hydration, and reduce the risk of aspiration pneumonitis. We evaluated the impact of modified barium swallow in determining PEG placements and the influe...

    journal_title:Journal of clinical gastroenterology

    pub_type: 杂志文章

    doi:10.1097/00004836-199703000-00005

    authors: Akpunonu BE,Mutgi AB,Roberts C,Khuder SA,Federman DJ,Lee L

    更新日期:1997-03-01 00:00:00

  • Chronic Epstein-Barr virus infection: a cause of granulomatous hepatitis?

    abstract::A 37-year-old man had fever, weight loss, malaise, right upper quadrant pain, lymphadenopathy, and a twofold elevation of serum alkaline phosphatase, transaminases, and gamma glutamyl transpeptidase. Granulomas were found on liver biopsy after 2 1/2 months of illness. Treatment with isoniazid and rifampin for 2 months...

    journal_title:Journal of clinical gastroenterology

    pub_type: 杂志文章

    doi:10.1097/00004836-198906000-00021

    authors: Biest S,Schubert TT

    更新日期:1989-06-01 00:00:00

  • A randomized, controlled trial of interactive, multimedia software for patient colonoscopy education.

    abstract::The purpose of our study was to assess the effectiveness of computer-assisted instruction (CAI) in patients having colonoscopies. We conducted a randomized, controlled trial in large, multispecialty clinic. Eighty-six patients were referred for colonoscopies. The interventions were standard education versus standard e...

    journal_title:Journal of clinical gastroenterology

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1097/00004836-200102000-00010

    authors: Shaw MJ,Beebe TJ,Tomshine PA,Adlis SA,Cass OW

    更新日期:2001-02-01 00:00:00

  • Computerized phonoenterography: the clinical investigation of a new system.

    abstract::We assessed bowel sounds in controls and patients with acute abdominal conditions using a new computer-aided sound analysis system (C.A.S.A.S.). Sixty-three controls and 61 patients with an acute abdomen had 10-min recordings of bowel sounds in a silent environment with computer analysis of the digitized acoustic sign...

    journal_title:Journal of clinical gastroenterology

    pub_type: 杂志文章

    doi:

    authors: Sugrue M,Redfern M

    更新日期:1994-03-01 00:00:00

  • Detailed history and examination assist positive clinical diagnosis of the irritable bowel syndrome.

    abstract::A detailed history and examination removes much of the vagueness from the symptoms of irritable bowel syndrome patients. The syndrome is much more homogeneous than suggested by the patient's complaints. Detailed questioning and examination contribute to further information in over two-thirds of patients. Examination r...

    journal_title:Journal of clinical gastroenterology

    pub_type: 杂志文章

    doi:10.1097/00004836-198312000-00005

    authors: Fielding JF

    更新日期:1983-12-01 00:00:00

  • Hepatotoxicity due to antituberculosis therapy. Clinical profile and reintroduction of therapy.

    abstract::The clinical profile of antituberculosis treatment (ATT)-induced hepatotoxicity is variable, and the reintroduction of ATT in patients who have developed such injury is controversial. We conducted a prospective study to determine the clinical profile in patients with ATT-induced hepatotoxicity and to test a predefined...

    journal_title:Journal of clinical gastroenterology

    pub_type: 杂志文章

    doi:10.1097/00004836-199604000-00012

    authors: Singh J,Garg PK,Tandon RK

    更新日期:1996-04-01 00:00:00

  • Juvenile chronic pancreatitis--a cause of painless jaundice in a patient with multiple somatic abnormalities.

    abstract::Juvenile chronic pancreatitis presenting with painless obstructive jaundice is extremely rare. Pancreatic disease in association with multiple somatic abnormalities presenting in late childhood is uncommon. We report such a case. ...

    journal_title:Journal of clinical gastroenterology

    pub_type: 杂志文章

    doi:10.1097/00004836-198512000-00019

    authors: Isaacs JD,Keshavarzian A,Blumgart LH,Hodgson HJ

    更新日期:1985-12-01 00:00:00

  • The gut barrier: new acquisitions and therapeutic approaches.

    abstract::The intestinal barrier serves 2 critical functions for the survival of the individual: first, it allows nutrient absorption and second, it defends the body from dangerous macromolecule penetration. It is a complex multilayer system, consisting of an external "anatomic" barrier and an inner "functional" immunological b...

    journal_title:Journal of clinical gastroenterology

    pub_type: 杂志文章,评审

    doi:10.1097/MCG.0b013e31826ae849

    authors: Scaldaferri F,Pizzoferrato M,Gerardi V,Lopetuso L,Gasbarrini A

    更新日期:2012-10-01 00:00:00

  • Higher incidence of diabetes in liver transplant recipients with hepatitis C.

    abstract::We assessed the clinical and biochemical parameters associated with the development of posttransplantation diabetes (PTDM) in 52 liver transplant recipients followed up for 1 year. Diabetes was present before transplantation in 9.6% (5 of 52) of patients, and PTDM occurred in 23% (11 of 47) of the remaining liver tran...

    journal_title:Journal of clinical gastroenterology

    pub_type: 杂志文章

    doi:10.1097/00004836-199801000-00009

    authors: Knobler H,Stagnaro-Green A,Wallenstein S,Schwartz M,Roman SH

    更新日期:1998-01-01 00:00:00

  • Pathophysiology and Therapeutic Options for Fecal Incontinence.

    abstract::Fecal incontinence (FI), defined as the involuntary loss of solid or liquid feces through the anus is a prevalent condition with significant effects on quality of life. FI can affect individuals of all ages and in many cases greatly impairs quality of life but, incontinent patients should not accept their debility as ...

    journal_title:Journal of clinical gastroenterology

    pub_type: 杂志文章,评审

    doi:10.1097/MCG.0000000000000797

    authors: Guillaume A,Salem AE,Garcia P,Chander Roland B

    更新日期:2017-04-01 00:00:00

  • Rates of Duodenal Biopsy During Upper Endoscopy Differ Widely Between Providers: Implications for Diagnosis of Celiac Disease.

    abstract:GOAL:The goal of this study is to determine factors associated with performance of duodenal biopsy during upper endoscopy. BACKGROUND:Celiac disease (CD) prevalence approaches 1% in the United States and Europe, yet CD remains underdiagnosed, in part because of low rates of duodenal biopsy during upper endoscopy. We a...

    journal_title:Journal of clinical gastroenterology

    pub_type: 杂志文章

    doi:10.1097/MCG.0000000000000957

    authors: Pitman M,Sanders DS,Green PHR,Lebwohl B

    更新日期:2019-02-01 00:00:00

  • Serous cystadenoma in communication with the pancreatic duct: an unusual radiologic and pathologic entity.

    abstract::Cross-sectional imaging is frequently used in the diagnosis of pancreatic cysts, but there can be overlap in radiographic appearance. We present a case of a patient with presumed intraductal papillary mucinous neoplasm (IPMN) who was ultimately found to have a serous cystadenoma in communication with the pancreatic du...

    journal_title:Journal of clinical gastroenterology

    pub_type: 杂志文章

    doi:10.1097/MCG.0b013e3181d3458d

    authors: Berman L,Mitchell KA,Israel G,Salem RR

    更新日期:2010-07-01 00:00:00

  • The Impact of Stool Consistency on Bowel Movement Satisfaction in Patients With IBS-C or CIC Treated With Linaclotide or Other Medications: Real-World Evidence From the CONTOR Study.

    abstract:GOALS:This study aimed to characterize the impact of stool consistency on patient-reported bowel movement (BM) satisfaction in patients with irritable bowel syndrome with constipation (IBS-C) or chronic idiopathic constipation, with a focus on linaclotide. BACKGROUND:As new medications for constipation become availabl...

    journal_title:Journal of clinical gastroenterology

    pub_type: 杂志文章

    doi:10.1097/MCG.0000000000001245

    authors: Taylor DCA,Abel JL,Doshi JA,Martin C,Goolsby Hunter A,Essoi B,Korrer S,Reasner DS,Carson RT,Chey WD

    更新日期:2019-11-01 00:00:00