Dilatation Therapy and Demographic Characteristics Significantly Influence the Amount of Propofol for Therapeutic Endoscopic Retrograde Cholangiography. (1st July 2019)

• Record Type: Journal Article
• Authors: Schmidt, Christoph A.; Keil, Carsten; Kirstein, Martha M.; Lehner, Frank; Manns, Michael P.; von Hahn, Thomas; Lankisch, Tim O.; Voigtländer, Torsten
• Other Names: Gordon Fredric D. Academic Editor.
• Is Part Of: International journal of hepatology. Volume 2019(2019)
• Publication Date: 2019-07-01
• Subjects: Hepatology -- Periodicals; Liver Diseases; Gastroenterology; Hepatology; Electronic journals; Periodicals; Periodicals; Fulltext; Internet Resources; Periodicals; 616.3
• DOI: 10.1155/2019/4793096
• Languages: English
• ISSNs: 2090-3448

Abstract

Abstract : Background and Study Aims . Patients undergoing therapeutic endoscopic retrograde cholangiography (ERC) may require different amounts of sedative agents depending on demographic characteristics, indication of ERC, and/or endoscopic intervention. Patients and Methods . We retrospectively analyzed all patients undergoing therapeutic ERC from 2008 – 2014 who received deep sedation with propofol ± midazolam. Results . A total of 2448 ERC procedures were performed in 781 patients. The cumulative per procedure propofol dose in the different groups was as follows: PSC 479 mg (±256), bile duct stones 356 mg (±187), benign stenosis/cholestasis 395 mg (±228), malignant stenosis 401 mg (±283), and postliver transplant complications 391 mg (±223) (p < 0.05). Multivariable analysis showed that dilatation therapy (p = 0.001), age (p = 0.001), duration of the intervention (p = 0.001), BMI (p = 0.001), gender (p = 0.001), platelet count (p = 0.003), and bilirubin (p = 0.043) influence independently the propofol consumption. Conclusions . Demographic characteristics and endoscopic interventions have a distinct influence on the amount of sedation required for therapeutic ERC. Although the sedation-associated complication rate is low optimization of sedative regimens is a prime goal to further reduce adverse events of therapeutic ERC.