title: Gastroenterologist-guided sedation with propofol for endoscopic ultrasonography in average-risk and high-risk patients:  a prospective series.
abstract: OBJECTIVE
  Only a few reports have addressed non-anesthesiologist-administered propofol for endoscopic ultrasonography (EUS), but none specifically in high-risk patients. Our aim was to study the application of a propofol sedation protocol for EUS in average-risk and high-risk patients.
  
  
  METHODS
  This was a prospective observational study including 446 patients referred for EUS. We analyzed the induction time, procedure duration, recovery times, and patients' comfort and safety. Sedation was administered by a trained nurse, under the guidance of the endoscopist. We continuously monitored vital signs as well as patient cooperation and tolerance. Complications, patient, and endoscopist satisfaction were analyzed.
  
  
  RESULTS
  No major complications occurred. The rate of minor complications was 9%, the most frequent being hypoxemia (8%). One hundred and thirty-eight high-risk patients were included [American Society of Anesthesiologists (ASA) III-IV]. Average-risk patients received higher propofol doses (202.9 ± 84.8 vs. 164.8 ± 84.3; P=0.003). No differences were found in the rate of complications or procedure-related variables. Overall patient and endoscopist satisfaction was excellent. The logistic regression model identified propofol doses (P=0.02) as a risk factor and ASA-I classification (P=0.03) as a protective factor for the appearance of complications.
  
  
  CONCLUSIONS
  Non-anesthesiologist-administered propofol for upper EUS in high-risk and average-risk patients is safe and could be routinely offered to high-risk and elderly patients.
authors.affiliation: Endoscopy Unit, Department of Gastroenterology and Hepatology, Hospital Universitario Virgen de Nieves, Granada, Spain. eredondoc@gmail.com
authors.forename: Eduardo
authors.initials: E
authors.lastname: Redondo-Cerezo
authors.forename: Antonio
authors.initials: A
authors.lastname: Sánchez-Robaina
authors.forename: Juan Gabriel
authors.initials: JG
authors.lastname: Martínez Cara
authors.forename: Manuel
authors.initials: M
authors.lastname: Ojeda-Hinojosa
authors.forename: Ana
authors.initials: A
authors.lastname: Matas-Cobos
authors.forename: Antonio Damián
authors.initials: AD
authors.lastname: Sánchez Capilla
authors.forename: Mercedes
authors.initials: M
authors.lastname: López de Hierro Ruíz
authors.forename: Julio
authors.initials: J
authors.lastname: Pleguezuelo-Díaz
authors.forename: Javier
authors.initials: J
authors.lastname: de Teresa
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001291:Attitude of Health Personnel; D016292:Procedural Sedation / Q000009:adverse effects / Q000379:methods* / Q000451:nursing; D004334:Drug Administration Schedule; D016099:Endoscopy, Gastrointestinal / Q000009:adverse effects / Q000379:methods*; D019160:Endosonography / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D015742:Propofol / Q000008:administration & dosage*; D011446:Prospective Studies; D018570:Risk Assessment / Q000379:methods; D013997:Time Factors; D055815:Young Adult
chemical_list: D006993:Hypnotics and Sedatives; D015742:Propofol