title: Low effect-site concentration of propofol target-controlled infusion reduces the risk of hypotension during endoscopy in a Taiwanese population.
abstract: OBJECTIVE
  Target-controlled infusion (TCI) of propofol is an effective way of delivering propofol during endoscopy. However, the ideal effect-site concentration (Ce) of propofol has not yet been defined in an Asian population. This study aimed to determine the ideal Ce of propofol in painless gastrointestinal endoscopy in a Taiwanese population.
  
  
  METHODS
  A total of 121 consecutive patients undergoing diagnostic endoscopy were recruited for this study. The endoscopic procedure was carried out within 1 h. TCI of propofol was utilized during the procedure. All patients received the same regimen to induce conscious sedation, including a bolus of midazolam (0.04 mg/kg) and fentanyl (0.5 μg/kg). The Ce of propofol was calculated using the Schneider model. Patients were randomly assigned to either the low Ce group (1.5-2.5 μg/mL) or high Ce group (3.0-4.0 μg/mL). Their cardiovascular and respiratory events were monitored during the procedure and the patients' post-procedure satisfaction was evaluated.
  
  
  RESULTS
  The mean requirement for propofol was 232.02 mg in the low Ce group and 329.56 mg in the high Ce group, respectively (P < 0.0001). No unexpected event was observed in either group. However, more episodes of hypotension were observed in the high Ce group (P = 0.026). The post-procedure satisfaction rate between the two groups was comparable.
  
  
  CONCLUSIONS
  A low Ce of propofol TCI (1.5-2.5 μg/mL) achieved adequate anesthesia, reduced the risk of hypotension, and attained a high satisfaction rate in a Taiwanese population undergoing diagnostic painless endoscopy.
authors.affiliation: Division of Internal Medicine, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung, Taiwan, China.
authors.forename: Wen-Hung
authors.initials: WH
authors.lastname: Hsu
authors.forename: Sophie S W
authors.initials: SS
authors.lastname: Wang
authors.forename: Hsiang-Yao
authors.initials: HY
authors.lastname: Shih
authors.forename: Meng-Chieh
authors.initials: MC
authors.lastname: Wu
authors.forename: Yi-Yu
authors.initials: YY
authors.lastname: Chen
authors.forename: Fu-Chen
authors.initials: FC
authors.lastname: Kuo
authors.forename: Hui-Ying
authors.initials: HY
authors.lastname: Yang
authors.forename: Shun-Li
authors.initials: SL
authors.lastname: Chiu
authors.forename: Koung-Shing
authors.initials: KS
authors.lastname: Chu
authors.forename: Kuang-I
authors.initials: KI
authors.lastname: Cheng
authors.forename: Deng-Chyang
authors.initials: DC
authors.lastname: Wu
authors.forename: I-Cheng
authors.initials: IC
authors.lastname: Lu
mesh_terms: D000328:Adult; D000368:Aged; D018686:Anesthetics, Intravenous / Q000008:administration & dosage* / Q000009:adverse effects; D016292:Procedural Sedation / Q000379:methods; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D016099:Endoscopy, Gastrointestinal / Q000009:adverse effects* / Q000379:methods; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage* / Q000009:adverse effects; D007022:Hypotension / Q000209:etiology / Q000517:prevention & control*; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D015742:Propofol / Q000008:administration & dosage* / Q000009:adverse effects
chemical_list: D018686:Anesthetics, Intravenous; D006993:Hypnotics and Sedatives; D015742:Propofol