title: Outcomes of Propofol Sedation During Emergency Endoscopy Performed for Upper Gastrointestinal Bleeding.
abstract: BACKGROUND
  Although propofol-based sedation can be used during emergency endoscopy for upper gastrointestinal bleeding (UGIB), there is a potential risk of sedation-related adverse events, especially in patients with variceal bleeding.
  
  
  OBJECTIVE
  We compared adverse events related to propofol-based sedation during emergency endoscopy between patients with non-variceal and variceal bleeding.
  
  
  METHODS
  Clinical records of patients who underwent emergency endoscopy for UGIB under sedation were reviewed. Adverse events, including shock, hypoxia, and paradoxical reaction, were compared between the non-variceal and variceal bleeding groups.
  
  
  RESULTS
  Of 703 endoscopies, 539 and 164 were performed for non-variceal and variceal bleeding, respectively. Shock was more common in patients with variceal bleeding compared to those with non-variceal bleeding (12.2 vs. 3.5%, P < 0.001). All patients except one recovered from shock after normal saline hydration, and emergency endoscopy could be finished without interruption in most cases. The incidence of hypoxia and paradoxical reaction did not differ based on the source of bleeding (non-variceal bleeding vs. variceal bleeding: hypoxia, 3.5 vs. 1.8%, P = 0.275; paradoxical reaction interfering with the procedure, 4.1 vs. 5.5%, P = 0.442).
  
  
  CONCLUSIONS
  Although shock was more common in patients with variceal bleeding compared to those with non-variceal bleeding, most cases could be controlled without procedure interruption. Paradoxical reaction, rather than shock or hypoxia, was the most common cause of procedure interruption in patients with variceal bleeding, but the rate did not differ between patients with non-variceal and variceal bleeding.
authors.affiliation: Department of Internal Medicine, Guri Hospital, Hanyang University College of Medicine, 153 Gyeongchun-ro, Guri, 471-701, Republic of Korea.
authors.forename: Chan Hyuk
authors.initials: CH
authors.lastname: Park
authors.affiliation: Department of Internal Medicine, Guri Hospital, Hanyang University College of Medicine, 153 Gyeongchun-ro, Guri, 471-701, Republic of Korea. hands@hanyang.ac.kr.
authors.forename: Dong Soo
authors.initials: DS
authors.lastname: Han
authors.affiliation: Department of Internal Medicine, Guri Hospital, Hanyang University College of Medicine, 153 Gyeongchun-ro, Guri, 471-701, Republic of Korea.
authors.forename: Jae Yoon
authors.initials: JY
authors.lastname: Jeong
authors.affiliation: Department of Internal Medicine, Guri Hospital, Hanyang University College of Medicine, 153 Gyeongchun-ro, Guri, 471-701, Republic of Korea.
authors.forename: Chang Soo
authors.initials: CS
authors.lastname: Eun
authors.affiliation: Department of Internal Medicine, Guri Hospital, Hanyang University College of Medicine, 153 Gyeongchun-ro, Guri, 471-701, Republic of Korea.
authors.forename: Kyo-Sang
authors.initials: KS
authors.lastname: Yoo
authors.affiliation: Department of Internal Medicine, Guri Hospital, Hanyang University College of Medicine, 153 Gyeongchun-ro, Guri, 471-701, Republic of Korea.
authors.forename: Yong Cheol
authors.initials: YC
authors.lastname: Jeon
authors.affiliation: Department of Internal Medicine, Guri Hospital, Hanyang University College of Medicine, 153 Gyeongchun-ro, Guri, 471-701, Republic of Korea.
authors.forename: Joo Hyun
authors.initials: JH
authors.lastname: Sohn
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000925:Anticoagulants / Q000627:therapeutic use; D002561:Cerebrovascular Disorders / Q000453:epidemiology; D015331:Cohort Studies; D015897:Comorbidity; D003920:Diabetes Mellitus / Q000453:epidemiology; D004359:Drug Therapy, Combination; D004630:Emergencies; D016099:Endoscopy, Gastrointestinal / Q000379:methods*; D004932:Esophageal and Gastric Varices / Q000453:epidemiology / Q000601:surgery*; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000453:epidemiology / Q000601:surgery*; D006489:Hemostatic Techniques; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D006993:Hypnotics and Sedatives / Q000009:adverse effects*; D000860:Hypoxia / Q000139:chemically induced*; D008103:Liver Cirrhosis / Q000453:epidemiology; D008297:Male; D008309:Mallory-Weiss Syndrome / Q000453:epidemiology / Q000601:surgery*; D008874:Midazolam / Q000627:therapeutic use; D008875:Middle Aged; D010438:Peptic Ulcer Hemorrhage / Q000453:epidemiology / Q000601:surgery*; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D015742:Propofol / Q000009:adverse effects*; D056910:Republic of Korea; D012189:Retrospective Studies; D012307:Risk Factors; D012769:Shock / Q000139:chemically induced*
chemical_list: D000925:Anticoagulants; D006993:Hypnotics and Sedatives; D010975:Platelet Aggregation Inhibitors; D008874:Midazolam; D015742:Propofol
keywords: Emergency endoscopy; Hemostasis; Propofol; Sedation; Variceal bleeding