title: Propofol sedation during endoscopic treatment for early gastric cancer compared to midazolam.
abstract: Endoscopic submucosal dissection (ESD) has been proposed as the gold standard in the treatment of early gastric cancer because it facilitates a more accurate histological assessment and reduces the risk of tumor recurrence. However, the time course of ESD for large gastric tumors is frequently prolonged because of the tumor size and technical difficulties and typically requires higher doses of sedative and pain-controlling drugs. Sedative or anesthetic drugs such as midazolam or propofol are used during the procedure. Therapeutic endoscopy of early gastric cancers can often be performed with only moderate sedation. Compared with midazolam, propofol has a very fast onset of action, short plasma half-life and time to achieve sedation, faster time to recovery and discharge, and results in higher patient satisfaction. For overall success, maintaining safety and stability not only during the procedure but also subsequently in the recovery room and ward is necessary. In obese patients, it is recommended that the injected dose be based on a calculated standard weight. Cooperation between gastroenterologists, surgeons, and anesthesiologists is imperative for a successful ESD procedure.
authors.affiliation: Shinsuke Kiriyama, Hiroshi Naitoh, Department of Surgery, Gunma Chuo General Hospital, Maebashi, Gunma 371-0025, Japan.
authors.forename: Shinsuke
authors.initials: S
authors.lastname: Kiriyama
authors.affiliation: Shinsuke Kiriyama, Hiroshi Naitoh, Department of Surgery, Gunma Chuo General Hospital, Maebashi, Gunma 371-0025, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Naitoh
authors.affiliation: Shinsuke Kiriyama, Hiroshi Naitoh, Department of Surgery, Gunma Chuo General Hospital, Maebashi, Gunma 371-0025, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Kuwano
mesh_terms: D001835:Body Weight; D016292:Procedural Sedation / Q000009:adverse effects / Q000379:methods*; D004210:Dissection / Q000009:adverse effects / Q000379:methods*; D054796:Drug Dosage Calculations; D005773:Gastroscopy / Q000009:adverse effects; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage* / Q000009:adverse effects / Q000493:pharmacokinetics; D008874:Midazolam / Q000008:administration & dosage* / Q000009:adverse effects / Q000493:pharmacokinetics; D017060:Patient Satisfaction; D018579:Patient Selection; D015742:Propofol / Q000008:administration & dosage* / Q000009:adverse effects / Q000493:pharmacokinetics; D012307:Risk Factors; D013274:Stomach Neoplasms / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome
chemical_list: D006993:Hypnotics and Sedatives; D008874:Midazolam; D015742:Propofol
keywords: Endoscopic resection; Endoscopic submucosal dissection; Gastric cancer; Propofol; Sedation