title: Propofol-Based Sedation Versus General Anesthesia for Endoscopic Submucosal Dissection.
abstract: The main objective of this study is to evaluate general anesthesia or propofol-based sedation methods at gastric endoscopic submucosal dissection (ESD) procedures.The anesthetic method administered to cases undergoing upper gastrointestinal ESD between 2013 and 2015 was retrospectively investigated. Procedure time, lesion size, dissection speed, anesthesia time, adverse effects such as gag reflex, nausea, vomiting, cough, number of desaturation episodes (SpO2 < 90%), oropharyngeal suctioning requirements, hemorrhage, perforation, and amount of anesthetic medications were recorded.There were 54 and 37 patients who were administered sedation (group S) and general anesthesia (group G), respectively. The demographics of the groups were similar. The calculated dissection speed was significantly high in group G (36.02 ± 20.96 mm/min) compared with group S (26.04 ± 17.56 mm/min; P = 0.010). The incidence of nausea, cough, number of oropharyngeal suctioning, and desaturation episodes were significantly high in group S compared with that in group G (P < 0.5). While there was no difference between the groups in terms of hemodynamic parameters, in group S the use of propofol and in group G the use of midazolam and fentanyl were significantly higher (P < 0.05). Anesthesia time, postoperative anesthesia care unit, and hospital stay durations were not significantly different between the groups.General anesthesia increased dissection speed and enhanced endoscopist performance when compared with propofol-based sedation technique.
authors.affiliation: From the Anesthesiology and Reanimation Department (DAY, PA, YI, NK, MK); and Gastroenterology Department (FA, BÜ), Katip Çelebi University, İzmir Atatürk Education and Research Hospital, İzmir, Turkey.
authors.forename: Derya Arslan
authors.initials: DA
authors.lastname: Yurtlu
authors.forename: Fatih
authors.initials: F
authors.lastname: Aslan
authors.forename: Pinar
authors.initials: P
authors.lastname: Ayvat
authors.forename: Yasemin
authors.initials: Y
authors.lastname: Isik
authors.forename: Nesli
authors.initials: N
authors.lastname: Karakus
authors.forename: Belkis
authors.initials: B
authors.lastname: Ünsal
authors.forename: Mehmet
authors.initials: M
authors.lastname: Kizilkaya
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000768:Anesthesia, General / Q000009:adverse effects; D018686:Anesthetics, Intravenous / Q000008:administration & dosage / Q000009:adverse effects; D062186:Arterial Pressure; D016292:Procedural Sedation / Q000009:adverse effects; D004210:Dissection; D016099:Endoscopy, Gastrointestinal / Q000379:methods*; D005260:Female; D005283:Fentanyl / Q000008:administration & dosage; D005753:Gastric Mucosa / Q000601:surgery; D005770:Gastrointestinal Neoplasms / Q000601:surgery*; D006339:Heart Rate; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage* / Q000009:adverse effects; D007413:Intestinal Mucosa / Q000601:surgery; D008297:Male; D008874:Midazolam / Q000008:administration & dosage; D008875:Middle Aged; D061646:Operative Time; D020250:Postoperative Nausea and Vomiting / Q000139:chemically induced; D015742:Propofol / Q000008:administration & dosage* / Q000009:adverse effects
chemical_list: D018686:Anesthetics, Intravenous; D006993:Hypnotics and Sedatives; D008874:Midazolam; D005283:Fentanyl; D015742:Propofol