Safety and risk factors for difficult endoscopist-directed ERCP sedation in daily practice: a hospital-based case-control study
Rev. esp. enferm. dig
; 108(5): 240-245, mayo 2016. tab
Artigo
em Inglês
| IBECS
| ID: ibc-152762
Biblioteca responsável:
ES1.1
Localização: BNCS
ABSTRACT
Background:
There are limited data concerning endoscopistdirected endoscopic retrograde cholangiopancreatography deep sedation. The aim of this study was to establish the safety and risk factors for difficult sedation in daily practice. Patients andmethods:
Hospital-based, frequency matched case-control study. All patients were identified from a database of 1,008 patients between 2014 and 2015. The cases were those with difficult sedations. This concept was defined based on the combination of the receipt of high-doses of midazolam or propofol, poor tolerance, use of reversal agents or sedation-related adverse events. The presence of different factors was evaluated to determine whether they predicted difficult sedation.Results:
One-hundred and eighty-nine patients (63 cases, 126 controls) were included. Cases were classified in terms of high-dose requirements (n = 35, 55.56%), sedation-related adverse events (n = 14, 22.22%), the use of reversal agents (n = 13, 20.63%) and agitation/discomfort (n = 8, 12.7%). Concerning adverse events, the total rate was 1.39%, including clinically relevant hypoxemia (n = 11), severe hypotension (n = 2) and paradoxical reactions to midazolam (n = 1). The rate of hypoxemia was higher in patients under propofol combined with midazolam than in patients with propofol alone (2.56% vs. 0.8%, p < 0.001). Alcohol consumption (OR 2.674 [CI 95% 1.098-6.515], p = 0.030), opioid consumption (OR 2.713 [CI 95% 1.096-6.716], p = 0.031) and the consumption of other psychoactive drugs (OR 2.015 [CI 95% 1.017-3.991], p = 0.045) were confirmed to be independent risk factors for difficult sedation.Conclusions:
Endoscopist-directed deep sedation during endoscopic retrograde cholangiopancreatography is safe. The presence of certain factors should be assessed before the procedure to identify patients who are high-risk for difficult sedation (AU)RESUMEN
No disponible
Texto completo:
Disponível
Coleções:
Bases de dados nacionais
/
Espanha
Contexto em Saúde:
Agenda de Saúde Sustentável para as Américas
/
ODS3 - Saúde e Bem-Estar
/
ODS3 - Meta 3.5 Prevenção e tratamento do consumo de substâncias psicoativas
Problema de saúde:
Objetivo 9: Redução de doenças não transmissíveis
/
Meta 3.4: Reduzir as mortes prematuras devido doenças não transmissíveis
/
Álcool
Base de dados:
IBECS
Assunto principal:
Midazolam
/
Propofol
/
Fatores de Risco
/
Colangiopancreatografia Retrógrada Endoscópica
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Endoscopia
/
Sedação Profunda
Tipo de estudo:
Estudo de etiologia
/
Estudo de avaliação
/
Estudo observacional
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Estudo prognóstico
/
Fatores de risco
Limite:
Feminino
/
Humanos
/
Masculino
Idioma:
Inglês
Revista:
Rev. esp. enferm. dig
Ano de publicação:
2016
Tipo de documento:
Artigo
Instituição/País de afiliação:
Hospital Morales Meseguer/Spain
/
Hospital Universitario Lucus Augusti/Spain