title: Safety of Target-Controlled Propofol Infusion by Gastroenterologists in Patients Undergoing Endoscopic Resection.
abstract: A target-controlled infusion (TCI) of a propofol system uses a pharmacokinetic model to achieve and maintain a selected target blood propofol concentration. The aim of this study was to assess whether the propofol TCI system could be safely used by gastroenterologists in patients undergoing endoscopic resection including endoscopic submucosal dissection (ESD) and endoscopic mucosal resection (EMR) compared with a manually controlled infusion (MCI) system.
  
  
  
  A total of 431 patients undergoing therapeutic endoscopy (178 ESD and 253 EMR) were consecutively included from November 2011 to August 2014. The patients were divided into the MCI (271) and TCI (160) propofol infusion groups. We compared adverse event rates in MCI and TCI groups and assessed independent risk factors for adverse events.
  
  
  
  The total sedation-related adverse event rate was 5.8 % (25/431). Most of the events were minor, and the rate of major events was 0.5 % (2/431). There was no significant difference in adverse event rate between the MCI and TCI groups [5.5 % (15/271) vs. 6.3 % (10/160); P = 0.759]. In univariate analysis, the propofol infusion time was significantly associated with adverse events (94.88 vs. 59.45 min, P = 0.017). In the multivariate analysis, there were no significant factors associated with adverse events. TCI was not an independent risk factor for adverse events despite the fact that the TCI had a longer duration of infusion and higher total infusion dose (95 % CI, 0.343-2.216; P = 0.773).
  
  
  
  TCI of propofol by gastroenterologists may provide safe sedation in patients undergoing ESD and EMR under careful respiratory monitoring.
authors.affiliation: Department of Internal Medicine, Hallym University College of Medicine, Seoul, Korea.
authors.forename: Seung In
authors.initials: SI
authors.lastname: Seo
authors.affiliation: Department of Internal Medicine, Hallym University College of Medicine, Seoul, Korea.
authors.forename: Ji Yon
authors.initials: JY
authors.lastname: Ryu
authors.affiliation: Department of Anesthesiology, Hallym University College of Medicine, Seoul, Korea.
authors.forename: Sang Soo
authors.initials: SS
authors.lastname: Kang
authors.affiliation: Department of Clinical Immunology, Hallym University College of Medicine, Seoul, Korea.
authors.forename: Jin Seo
authors.initials: JS
authors.lastname: Lee
authors.affiliation: Department of Internal Medicine, Hallym University College of Medicine, Seoul, Korea.
authors.forename: Hyoung Su
authors.initials: HS
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Hallym University College of Medicine, Seoul, Korea.
authors.forename: Myoung Kuk
authors.initials: MK
authors.lastname: Jang
authors.affiliation: Department of Internal Medicine, Hallym University College of Medicine, Seoul, Korea.
authors.forename: Hak Yang
authors.initials: HY
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Hallym University College of Medicine, Seoul, Korea. sgun9139@gmail.com.|Department of Clinical Immunology, Hallym University College of Medicine, Seoul, Korea. sgun9139@gmail.com.|Division of Gastroenterology, Department of Internal Medicine, Kangdong Sacred Heart Hospital, 445, Gil-dong, Kangdong-gu, Seoul, 134-701, Korea. sgun9139@gmail.com.
authors.forename: Woon Geon
authors.initials: WG
authors.lastname: Shin
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D018686:Anesthetics, Intravenous / Q000008:administration & dosage* / Q000009:adverse effects; D016022:Case-Control Studies; D054810:Deep Sedation / Q000379:methods*; D000069916:Endoscopic Mucosal Resection / Q000379:methods*; D016145:Endoscopy, Digestive System / Q000379:methods*; D005260:Female; D000072102:Gastroenterologists; D006336:Heart Massage / Q000706:statistics & numerical data; D006606:Hiccup / Q000139:chemically induced; D006801:Humans; D007022:Hypotension / Q000139:chemically induced / Q000188:drug therapy; D000860:Hypoxia / Q000139:chemically induced / Q000628:therapy; D007262:Infusions, Intravenous; D007442:Intubation, Intratracheal / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D015742:Propofol / Q000008:administration & dosage* / Q000009:adverse effects; D053120:Respiratory Aspiration / Q000139:chemically induced; D012189:Retrospective Studies; D012913:Snoring / Q000139:chemically induced; D014662:Vasoconstrictor Agents / Q000627:therapeutic use; D055815:Young Adult
chemical_list: D018686:Anesthetics, Intravenous; D014662:Vasoconstrictor Agents; D015742:Propofol
keywords: Adverse event; Endoscopic resection; Manually controlled infusion; Sedation; Target-controlled infusion