title: Balanced propofol sedation for therapeutic GI endoscopic procedures: a prospective, randomized study.
abstract: BACKGROUND
  There are few controlled studies on balanced propofol sedation (BPS) for therapeutic endoscopy.
  
  
  OBJECTIVE
  To compare the safety and efficacy of BPS (propofol in combination with midazolam and meperidine) with conventional sedation (midazolam and meperidine) in patients undergoing therapeutic endoscopic procedures.
  
  
  METHODS
  Prospective, randomized, single-blinded study.
  
  
  METHODS
  Tertiary-care referral center.
  
  
  METHODS
  This study involved 222 consecutive patients undergoing therapeutic EGD or ERCP from July 2009 to March 2010.
  
  
  METHODS
  Conventional sedation or BPS by trained registered nurses under endoscopist supervision.
  
  
  METHODS
  Rates of sedation-related cardiopulmonary complications and interruption of the procedures, procedure-related times, and assessments of health care providers (endoscopists and sedation nurses) and patients.
  
  
  RESULTS
  There were no significant differences between the BPS and conventional groups in the rates of cardiopulmonary complications (8.8% [9/102] vs 5.8% [6/104], respectively) and transient interruption of procedures (2.9% [3/102] vs 0% [0/104], respectively). No patient required assisted ventilation or premature termination of a procedure. BPS provided significantly higher health care provider satisfaction (mean±SD 10-cm visual analog scale [VAS] score) compared with conventional sedation (endoscopists: 7.57±2.61 vs 6.55±2.99, respectively; P=.011; sedation nurses: 7.86±2.31 vs 6.67±2.90, respectively; P=.001). Patient cooperation was significantly better in the BPS group (VAS; endoscopists: 7.24±2.97 vs 6.27±3.09, P=.024; sedation nurses: 7.75±2.30 vs 6.54±2.99, P=.001).
  
  
  CONCLUSIONS
  Single-center and single-blinded study.
  
  
  CONCLUSIONS
  Compared with conventional sedation, BPS provides higher health care provider satisfaction, better patient cooperation, and similar adverse event profiles in patients undergoing therapeutic endoscopic procedures.
authors.affiliation: Department of Internal Medicine, Kyung Hee University School of Medicine, Seoul, Korea.
authors.forename: Chang Kyun
authors.initials: CK
authors.lastname: Lee
authors.forename: Suck-Ho
authors.initials: SH
authors.lastname: Lee
authors.forename: Il-Kwun
authors.initials: IK
authors.lastname: Chung
authors.forename: Tae Hoon
authors.initials: TH
authors.lastname: Lee
authors.forename: Sang-Heum
authors.initials: SH
authors.lastname: Park
authors.forename: Eun-Ok
authors.initials: EO
authors.lastname: Kim
authors.forename: Sae Hwan
authors.initials: SH
authors.lastname: Lee
authors.forename: Hong-Soo
authors.initials: HS
authors.lastname: Kim
authors.forename: Sun-Joo
authors.initials: SJ
authors.lastname: Kim
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018686:Anesthetics, Intravenous / Q000008:administration & dosage / Q000627:therapeutic use; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000379:methods; D016292:Procedural Sedation / Q000379:methods*; D004066:Digestive System Diseases / Q000175:diagnosis / Q000628:therapy*; D016099:Endoscopy, Gastrointestinal / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007275:Injections, Intravenous; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D015742:Propofol / Q000008:administration & dosage / Q000627:therapeutic use*; D011446:Prospective Studies; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D018686:Anesthetics, Intravenous; D015742:Propofol