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• W2008758375 abstract "Background/Aims: Endoscopic submucosal dissection (ESD) has recently been developed for endoscopic treatment of GI tumors. ESD is one of the most complex and lengthy endoscopic procedure. Thus, an appropriate sedation is indispensable to perform a steady procedure. As for propofol, stable sedation is provided. However, in case of over sedation, there is possibility of respiratory depression. The bispectral index (BIS), a parameter derived from the electroencephalograph (EEG), has been shown to correlate with increasing sedation and loss of consciousness. Target-controlled infusion (TCI) of propofol uses a pharmacokinetic model to maintain a selected target blood propofol concentration. For prevention of respiratory depression, we applied a combination of BIS monitoring and TCI system. We investigated the safety and efficacy of this combination method. Patients and Methods: A total of fifty eight consecutive esophageal and gastric cancer patients who treated by ESD under combination sedation method in our hospital were enrolled in this study (BIS+TCI group). Other twenty eight patients who treated ESD under propofol sedation without using BIS monitor and TCI system were compared as a control group. We compared two aspects of safety and effectiveness: (1) frequencies of body movement per hour, (2) rate of incidence of under 90% oxygen saturation. All patients were sedated under oxygen inhalation (2 L/min) by nasotrachial airway. Sedation was provided by a doctor with prior experiences in anesthesia. In BIS+TCI group, the propofol infusion (1% propofol) was started at an initial target blood concentration of 2.2 μg/mL. When BIS score became under 40, we decreased target blood concentration by 0.2 μg/mL, and when BIS score became over 80 or patient began to move, we increased target blood concentration by 0.2μg/mL. In control group, we administered propofol by conventional pump without using BIS monitor and TCI system. The initial intravenous dose of propofol was 1.0-1.4 mg/kg, and propofol was administered at 1.0-2.0mg/kg/hour continuously during the procedure. If the patient began to move, additional doses of propofol were administered by 0.4-0.6mg/kg. Results: (1) the mean body motion per hour in BIS+TCI group was significantly lower than that in control group (0.27 vs. 1.16, P<0.01). (2) rate of incidence of under 90% oxygen saturation in BIS+TCI group was lower than that in control group, though it was not significant (15.5% vs. 21.4%, P=0.50). Conclusion: Administration of propofol by using combination method of BIS monitor and TCI system can sedate more stably and safely than conventional method for ESD procedure." @default.
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• W2008758375 date "2009-04-01" @default.
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• W2008758375 title "The New Endoscopic Sedation Method: Administration of Popofol Using BIS Monitor and TCI System" @default.
• W2008758375 doi "https://doi.org/10.1016/j.gie.2009.03.530" @default.
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