title: An effective and safe sedation technique combining target-controlled infusion pump with propofol, intravenous pentazocine, and bispectral index monitoring for peroral double-balloon endoscopy.
abstract: OBJECTIVE
  Because peroral double-balloon endoscopy (DBE) is a time-consuming, painful procedure, sedation with analgesics, and/or anesthetics is generally required. The aim of this prospective study was to investigate the safety and efficacy of our sedation protocol for peroral DBE, which consisted of target-controlled infusion (TCI) anesthesia with propofol, an intravenous bolus of pentazocine, and bispectral index (BIS) monitoring.
  
  
  METHODS
  A total of 34 consecutive patients who underwent DBE by the oral approach were enrolled. Patients were primarily sedated with a continuous infusion of propofol and adjusted in accordance with the BIS levels. The bolus infusion of pentazocine was performed when the propofol infusion was insufficient. The primary outcome measure of this study was to ensure the safety and efficacy of this sedation technique. The secondary purpose was to identify the characteristics of the patient who required the bolus infusion of pentazocine.
  
  
  RESULTS
  Five patients (14.7%) required a reduction in the dose of propofol. However, no patient experienced any serious adverse events. All patients (100%) and 80.6% (25/31) of endoscopists answered that the sedation protocol was 'excellent' or 'enough' for peroral DBE. Eleven patients (32.3%) required a bolus injection of pentazocine. Age <60 years and a total procedure time of >70 min were significant risk-factors for pentazocine use.
  
  
  CONCLUSIONS
  A combination of propofol via TCI pump, bolus injection of pentazocine as needed, and BIS monitoring was a safe and effective procedure for peroral DBE. Reasonable satisfaction indices were obtained from both patients and endoscopists. Pentazocine was required for young patients and in cases with longer procedure times.
authors: Department of Endoscopy, Okayama University Hospital, Okayama, Japan.
authors: Seiji
authors: S
authors: Kawano
authors: Hiroyuki
authors: H
authors: Okada
authors: Masaya
authors: M
authors: Iwamuro
authors: Yoshiyasu
authors: Y
authors: Kouno
authors: Kou
authors: K
authors: Miura
authors: Toshihiro
authors: T
authors: Inokuchi
authors: Hiromitsu
authors: H
authors: Kanzaki
authors: Keisuke
authors: K
authors: Hori
authors: Keita
authors: K
authors: Harada
authors: Sakiko
authors: S
authors: Hiraoka
authors: Yoshiro
authors: Y
authors: Kawahara
authors: Kazuhide
authors: K
authors: Yamamoto
mesh_terms: D061605:Administration, Intravenous; D000328:Adult; D000367:Age Factors; D000368:Aged; D016292:Procedural Sedation / Q000379:methods*; D056805:Consciousness Monitors; D058582:Double-Balloon Enteroscopy / Q000379:methods*; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D007260:Infusion Pumps; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative / Q000295:instrumentation*; D061646:Operative Time; D010423:Pentazocine / Q000008:administration & dosage*; D015742:Propofol / Q000008:administration & dosage*; D011446:Prospective Studies; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D010423:Pentazocine; D015742:Propofol