Researchers from Washington University in St. Louis, Mo., found that propofol could be used safely under supervision of a trained professional for patients undergoing advanced endoscopic procedures, but some independent factors could contribute to an increased rate of airway modifications, according to a study published in the February issue of Clinical Gastroenterology and Hepatology.
The researchers studied 799 patients undergoing sedation with propofol for advanced endoscopic procedures, such as endoscopic retrograde cholangiopancreatography, endoscopic ultrasound and small-bowel enteroscopy. Sedative dosing was determined by a CRNA. They were monitored for sedation complications, namely AMs, hypoxemia, hypotension requiring vasopressors and early procedure termination AMs were defined as chin lift, modified face mask ventilation and nasal airway.
Of the 799 patients, 87.2 percent showed no response to endoscopic intubation; hypoxemia occurred in 12.8 percent, hypotension in 0.5 percent and premature termination in 0.6 percent. Researchers observed 154 AMs performed on 115 patients. These included chin lift (12.1 percent), modified face mask ventilation (3.6 percent) and nasal airway (3.5 percent).
The researchers concluded that propofol was safe for advanced endoscopic procedures when administered by a trained professional. Body mass index, male sex and ASA class of 3 or higher were independent predictors of AMs, according to the study.
Read the study on the use of propofol in advanced endoscopic procedures.