What sedation to use during endoscopic procedure.
Many endoscopists sometimes prefer to perform endoscopies without anaesthetic support, using only benzodiazepines. Endogenous opioid peptides are believed to play an important role in the modulation of pain within the endogenous analgesic system. A group of 40 patients undergoing diagnostic and therapeutic Endoscopic Retrograde Cholangiography and Pancreatography (ERCP) was recruited. Patients were divided into 2 groups according to Visual Analog Scale: pain 1-5 (Group A) and pain 6-10 (Group B). The beta-endorphin baseline values were significantly different between patients of Group A and Group B. Our data show that patients with levels of beta-endorphin over 8 pmol/L were less sensitive to pain, so that they become candidates for a traditional utilization of the benzodiazepines. However in the patients with beta-end levels less of 8 pmol/L should be suitable an anaesthetic as propofol because strong pain might provoke neurohumoral reflexes, cardiovascular alterations, and even a heart attack.
Tonnarini
G F
GF
Dipartimento di Scienze, Cliniche University of Rome "La Sapienza", Rome, Italy.
Parlapiano
C
C
Pironti
E
E
Pantone
P
P
Chinazzi
A
A
Restuccia
M R
MR
Antonaci
A
A
D000328:Adult; D000758:Anesthesia; D001569:Benzodiazepines; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000009:adverse effects*; D004723:Endorphins / Q000097:blood; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D015742:Propofol
D004723:Endorphins; D006993:Hypnotics and Sedatives; D001569:Benzodiazepines; D015742:Propofol