title: Effectiveness of outpatient percutaneous endoscopic gastrostomy replacement using esophagogastroduodenoscopy and propofol sedation.
abstract: OBJECTIVE
  To evaluate the effectiveness of outpatient percutaneous endoscopic gastrostomy (PEG) replacement using esophagogastroduodenoscopy (EGD) and propofol sedation.
  
  
  METHODS
  We retrospectively assessed the outcome and complications of consecutive patients referred for PEG replacement which was performed using EGD under propofol sedation in the outpatient setting. The success rate, the mean dose of propofol, procedure time, EGD findings, discharge time from endoscopy unit, respiratory depression, and complications within 72 h of the procedure were evaluated. In a subset of these patients, the blood concentrations of propofol were measured.
  
  
  RESULTS
  All 221 patients underwent successful PEG replacement. The mean dose of propofol was 34 mg (range, 20-60 mg) with a mean procedure time of 5.9 min (range, 3-8 min). Reflux esophagitis (12 patients), gastric ulcer (5), gastric neoplasm (2), and duodenal ulcer (1) were newly diagnosed at replacement. Discharge from endoscopy unit was possible in 100% of patients 45 min after the procedure. Only 3.6% (8) required transient supplemental oxygen. No complications occurred within 72 h of the procedure. During EGD the level of sedation and propofol blood concentrations after administration of propofol (30 mg) in these PEG patients corresponded to those of propofol (60 mg) in middle aged subjects (control).
  
  
  CONCLUSIONS
  PEG replacement using EGD and propofol sedationin the outpatient setting was safe and practical.
authors.affiliation: Akira Horiuchi, Yoshiko Nakayama, Masashi Kajiyama, Naoki Tanaka, Digestive Disease Center, Showa Inan General Hospital, Komagane, 399-4117 Matsumoto, Japan.
authors.forename: Akira
authors.initials: A
authors.lastname: Horiuchi
authors.forename: Yoshiko
authors.initials: Y
authors.lastname: Nakayama
authors.forename: Masashi
authors.initials: M
authors.lastname: Kajiyama
authors.forename: Naoki
authors.initials: N
authors.lastname: Tanaka