ABSTRACT
Background/Aims@#The aim of this study was to evaluate the safety of sedation with propofol as an alternative to benzodiazepine drugs in outpatient endoscopy. @*Methods@#In this prospective study, examinees who underwent outpatient endoscopy under propofol sedation and submitted a nextday questionnaire with providing informed consent were evaluated. Periprocedural acute responses, late adverse events within 24 hours, and examinee satisfaction were evaluated. @*Results@#Among the 4,122 patients who received propofol in the 17,978 outpatient-based endoscopic examinations performed between November 2016 and March 2018, 2,305 eligible examinees (esophagogastroduodenoscopy for 1,340, endoscopic ultrasonography for 945, and total colonoscopy for 20) were enrolled, and their responses to a questionnaire were analyzed. The mean propofol dose was 69.6±24.4 mg (range, 20–200 mg). Diazepam, midazolam, and/or pentazocine in combination with propofol was administered to 146 examinees. Mild oxygen desaturation was observed in 59 examinees (2.6%); and mild bradycardia, in 2 (0.09%). Other severe reactions or late events did not occur. After eliminating 181 invalid responses, 97.7% (2,065/2,124) of the patients desired propofol sedation in future examinations. @*Conclusions@#Propofol sedation was found to be safe—without severe adverse events or accidents—for outpatient endoscopy on the basis of the patients’ next-day self-evaluation. Given the high satisfaction level, propofol sedation might be an ideal tool for painless endoscopic screening.
ABSTRACT
Background/Aims@#The aim of this study was to evaluate the safety of sedation with propofol as an alternative to benzodiazepine drugs in outpatient endoscopy. @*Methods@#In this prospective study, examinees who underwent outpatient endoscopy under propofol sedation and submitted a nextday questionnaire with providing informed consent were evaluated. Periprocedural acute responses, late adverse events within 24 hours, and examinee satisfaction were evaluated. @*Results@#Among the 4,122 patients who received propofol in the 17,978 outpatient-based endoscopic examinations performed between November 2016 and March 2018, 2,305 eligible examinees (esophagogastroduodenoscopy for 1,340, endoscopic ultrasonography for 945, and total colonoscopy for 20) were enrolled, and their responses to a questionnaire were analyzed. The mean propofol dose was 69.6±24.4 mg (range, 20–200 mg). Diazepam, midazolam, and/or pentazocine in combination with propofol was administered to 146 examinees. Mild oxygen desaturation was observed in 59 examinees (2.6%); and mild bradycardia, in 2 (0.09%). Other severe reactions or late events did not occur. After eliminating 181 invalid responses, 97.7% (2,065/2,124) of the patients desired propofol sedation in future examinations. @*Conclusions@#Propofol sedation was found to be safe—without severe adverse events or accidents—for outpatient endoscopy on the basis of the patients’ next-day self-evaluation. Given the high satisfaction level, propofol sedation might be an ideal tool for painless endoscopic screening.
ABSTRACT
Afferent loop syndrome is often difficult to resolve. Among patients with afferent loop syndrome whose data were extracted from databases, 5 patients in whom metal stent placement was attempted were included and evaluated in this study. The procedure was technically successful without any adverse events in all patients. Metal stent(s) was placed with an endoscope in the through-the-scope manner in 4 patients and via a percutaneous route in 1 patient. Obvious clinical efficacy was observed in all patients. Adverse events related to the procedure and stent occlusion during the follow-up period were not observed. Metal stent placement for malignant obstruction of the afferent loop was found to be safe and feasible.
Subject(s)
Humans , Afferent Loop Syndrome , Endoscopes , Follow-Up Studies , Intestinal Obstruction , Palliative Care , Self Expandable Metallic Stents , Stents , Treatment OutcomeABSTRACT
To examine the relationships between anger expression and blood pressure (BP) levels and their effect modification by stress coping behaviors, the authors analyzed data from a cross−sectional study of 790 Japanese male workers aged 20−60 years. We used the Spielberger anger expression scales to measure anger−out, anger−in, and anger−control. Relationships between anger expression scales and mean systolic and diastolic BP levels were examined in the total sample and in two subgroups of high and low stress coping behaviors (low coping behavior group: having none, one, or two coping behaviors; and high coping behavior group: having three or more coping behaviors). Anger expression scales were not associated with BP levels in the total sample. Among men who reported only two or fewer coping behaviors, however, the anger−out score was significantly associated with systolic blood pressure (SBP) levels while no association was found among men who reported the larger number of coping behaviors. Anger−in and anger−control were not associated with BP levels in either low or high coping behavior groups. This study suggests that male workers who do not express their anger have a higher probability of developing high BP when they have no or few stress coping behaviors.