Background & Aims: Safety of propofol sedation in patients with liver cirrhosis undergoing colonoscopy or ERCP remains to be studied. Aim of the study was to investigate whether the use of propofol is safe for endoscopic procedures more complex than gastroscopy in patients with liver cirrhosis in a prospective controlled study Methods: Between January and June 2009, 214 consecutive patients, with or without cirrhosis, who underwent colonoscopy or ERCP with propofol sedation were recruited. Administration of sedation was performed by anesthesiologists and outcome measures were recorded. Main outcomes were complication rates and recovery times. Results: Sixty-one (28.5%) cirrhotic patients and 153 (71.5%) non-cirrhotics were included. The incidence of sedation-related complications did not significantly differ between the two populations (11.5% vs 17.0%, respectively, p=0.31). The mean (±SD) dose of propofol administered (213±86 vs 239±100 mg, p=0.07), the mean time to achieve adequate sedation (3.3±1.1 vs 3.0±1.2 min., p= 0.21), the mean total duration of the endoscopic procedure (24.5±10.6 vs 27.4±11.8 min., p=0.08), the mean time to reach Observer's Assessment of Alertness and Sedation Scale 5 (17.2±4.4 vs 18.4±5.6 min., p=0.15), the mean time from completion of the procedure to release (9.0±2.5 vs 9.1±3.2 min., p=0.86), the mean time to full recovery (42.2±7.3 vs 42.3±7.8 min., p= 0.88) were very close between the two groups. The limitation of the study was lack of randomization and of a control group of cirrhotics using standard sedation with benzodiazepines and opioids. Conclusions: Propofol deep sedation administered by an anesthesiologist with appropriate monitorings seems a safe procedure during colonoscopy or ERCP in cirrhotic patients.
Safety of propofol in cirrhotic patients undergoing colonoscopy and endoscopic retrograde cholangiography: results of a prospective controlled study.
FAGOONEE, SHARMILA;RIZZETTO, Mario;SARACCO, Giorgio Maria
2012-01-01
Abstract
Background & Aims: Safety of propofol sedation in patients with liver cirrhosis undergoing colonoscopy or ERCP remains to be studied. Aim of the study was to investigate whether the use of propofol is safe for endoscopic procedures more complex than gastroscopy in patients with liver cirrhosis in a prospective controlled study Methods: Between January and June 2009, 214 consecutive patients, with or without cirrhosis, who underwent colonoscopy or ERCP with propofol sedation were recruited. Administration of sedation was performed by anesthesiologists and outcome measures were recorded. Main outcomes were complication rates and recovery times. Results: Sixty-one (28.5%) cirrhotic patients and 153 (71.5%) non-cirrhotics were included. The incidence of sedation-related complications did not significantly differ between the two populations (11.5% vs 17.0%, respectively, p=0.31). The mean (±SD) dose of propofol administered (213±86 vs 239±100 mg, p=0.07), the mean time to achieve adequate sedation (3.3±1.1 vs 3.0±1.2 min., p= 0.21), the mean total duration of the endoscopic procedure (24.5±10.6 vs 27.4±11.8 min., p=0.08), the mean time to reach Observer's Assessment of Alertness and Sedation Scale 5 (17.2±4.4 vs 18.4±5.6 min., p=0.15), the mean time from completion of the procedure to release (9.0±2.5 vs 9.1±3.2 min., p=0.86), the mean time to full recovery (42.2±7.3 vs 42.3±7.8 min., p= 0.88) were very close between the two groups. The limitation of the study was lack of randomization and of a control group of cirrhotics using standard sedation with benzodiazepines and opioids. Conclusions: Propofol deep sedation administered by an anesthesiologist with appropriate monitorings seems a safe procedure during colonoscopy or ERCP in cirrhotic patients.
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