[Propofol sedation administered by nurses for endoscopic procedures].
BACKGROUND
As an increasing number of therapeutic and diagnostic procedures are performed endoscopically, the demand for sufficient sedation during endoscopy is rising. Propofol sedation administered by nurses (NAPS) has gained increasing popularity. NAPS was introduced at Gentofte Hospital in September 2007 after structured training at Roque Valley Surgical Center in Medford, Oregon, USA. The aim of the present study is to present our results with NAPS.


METHODS
Patients referred for endoscopy were monitored with regard to blood pressure, pulse oxymetry, electrocardiography and evaluation of their respiration during and after the procedure.


RESULTS
A total of 229 patients (233 endoscopic procedures) were included (ASA I: 68 (29%), ASA II: 116 (50%), ASA III: 44 (19%), ASA IV: 1 (0.4%)). The median propofol administration was 330 mg (variance 100-1,700 mg). Hypoxia, defined as oxygen < 92%, was observed in 18 patients. The hypoxia lasted less than 30 seconds in eight patients and between 30-60 seconds in eight cases. Two patients had hypoxia for a period exceeding 60 seconds. Propofol administration was discontinued in all 18 cases and increased oxygen flow was administered via a nasal tube. Short lasting manual mask ventilation was instituted in five patients. No serious events related to sedation were seen.


CONCLUSIONS
NAPS seem to be a suitable method for sedation in endoscopy and should be implemented in Denmark. However, proper training is required in collaboration with anaesthesiologists.
Vilmann
Peter
P
Gentofte Hospital, Kirurgisk Gastroenterologisk Afdeling, DK-2900 Hellerup. Pevi@geh.regionh.dk
Hornslet
Pernille
P
Simmons
Hanne
H
Hammering
Anne
A
Clementsen
Paul
P
D000293:Adolescent; D000328:Adult; D000368:Aged; D018686:Anesthetics, Intravenous / Q000008:administration & dosage*; D002983:Clinical Competence; D016292:Procedural Sedation / Q000379:methods / Q000451:nursing*; D004509:Education, Nursing, Continuing; D016099:Endoscopy, Gastrointestinal; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D009726:Nurses; D017063:Outcome Assessment, Health Care; D015742:Propofol / Q000008:administration & dosage*; D012449:Safety; D055815:Young Adult
D018686:Anesthetics, Intravenous; D006993:Hypnotics and Sedatives; D015742:Propofol