title: Efficacy of propofol sedation for endoscopic submucosal dissection (ESD): assessment with prospective data collection.
abstract: OBJECTIVE
  The indications for endoscopic treatment in early stage cancer of the digestive tract are expanding with the emergence and technical development of endoscopic submucosal dissection (ESD). ESD requires longer term stable sedation than conventional endoscopic procedures due to the necessity of meticulous control of the devices during the procedure. Propofol has a very short half-life and can be administered continuously, which is advantageous for long-term sedation. Propofol, thus, is likely to be useful for sedation during ESD.
  
  
  METHODS
  Fifty consecutive patients who underwent ESD for early gastric cancer with propofol sedation (Group P) and those with midazolam sedation (Group M) were included in this study. Cardiorespiratory suppression rate and the condition of arousal were compared between the groups. A questionnaire survey on the satisfaction of endoscopists, anesthesiologists, endoscopy nurses, and ward nurses with the use of propofol was also carried out.
  
  
  RESULTS
  Respiratory suppression was observed in 50% in Group M and in 20% in Group P (p<0.05). Hypotension was seen in 14% and 36% in Groups M and P, respectively (p<0.05). No sedation-related complications were encountered in either of the groups. Arousal rates 1 hour and 3 hours after the procedure were 23% and 60% in group M and 86% and 100% in Group P (p<0.05). As for the questionnaire survey, most respondents, in particular the ward nurses, supported the use of propofol.
  
  
  CONCLUSIONS
  Our data suggest that propofol is safe and useful during ESD as compared with midazolam.
authors.affiliation: Department of Gastroenterology, Sendai City Medical Center, Japan. yamagatataku19780618@yahoo.co.jp
authors.forename: Taku
authors.initials: T
authors.lastname: Yamagata
authors.forename: Dai
authors.initials: D
authors.lastname: Hirasawa
authors.forename: Naotaka
authors.initials: N
authors.lastname: Fujita
authors.forename: Takashi
authors.initials: T
authors.lastname: Suzuki
authors.forename: Takashi
authors.initials: T
authors.lastname: Obana
authors.forename: Toshiki
authors.initials: T
authors.lastname: Sugawara
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Ohira
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Harada
authors.forename: Yuki
authors.initials: Y
authors.lastname: Maeda
authors.forename: Yoshiki
authors.initials: Y
authors.lastname: Koike
authors.forename: Kenjiro
authors.initials: K
authors.lastname: Suzuki
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Noda
mesh_terms: D000368:Aged; D018686:Anesthetics, Intravenous / Q000008:administration & dosage* / Q000009:adverse effects; D002319:Cardiovascular System / Q000187:drug effects; D003864:Depression, Chemical; D004210:Dissection; D016099:Endoscopy, Gastrointestinal / Q000379:methods*; D005260:Female; D006207:Half-Life; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage* / Q000009:adverse effects; D008297:Male; D008874:Midazolam / Q000008:administration & dosage / Q000009:adverse effects; D008875:Middle Aged; D015742:Propofol / Q000008:administration & dosage* / Q000009:adverse effects; D011446:Prospective Studies; D012137:Respiratory System / Q000187:drug effects; D013274:Stomach Neoplasms / Q000601:surgery; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
chemical_list: D018686:Anesthetics, Intravenous; D006993:Hypnotics and Sedatives; D008874:Midazolam; D015742:Propofol