Z Gastroenterol 2006; 44 - A6
DOI: 10.1055/s-2006-943373

Endoscopic interventions performed in propofol anaesthesia in 2005

L Bene 1, C Tóth 1, E Rácz 2, Á Stogicza 2
  • 1E Dept of Internal Medicine and Gastroenterology, Péterfy S. Hospital Budapest
  • 2Dept of Anaesthesiology and Intensive Therapy, Péterfy S. Hospital Budapest

Aim of study: the proper premedication during gastro-intestinal endoscopic procedures is still an unresolved problem. It is commonly accepted that the 50% of the morbidity and mortality linked with the interventions is caused by cardiopulmonary complication and sedation. Recently several papers were published about the use of propofol in this setting. Properties of the propofol are the following: very quick onset of the effect, after discontinuation the effect diminishes quickly, but there is no antagonist agent.

Materials and methods: we performed 5108 endoscopic interventions in our departement. We used propofol in 72 patients. The age of the patients was between 30 an 92 years. We monitored the patients' blood pressure, ECG and the O2 saturation (pulsoxymetry).

Results: 9 patients were in stage ASA I, 11 in stage ASA II, 42 in stage ASA III and 10 in stage ASA IV. The dose of propofol was between 40 and 500mg. The starting dose in stages ASA I-II was between 60 and 100mg, in stages ASA III-IV between 40–60mg. We gave only propofol during 12 gastroscopies; we also administered Dormicum and Nubain during 32 intragstric balloon procedures and 28 colonoscopies. In stages ASA III-IV we used only propofol.

Complications: we observed no major complications, during pulsoxymetry the O2 saturation did not drop below 90%. Complications occured only in extreme obese patients. In one case we started the procedure with endotracheal intubation (ASA IV 200kg, 150cm, could not breath in lying position), in another case we performed endotracheal intubation during the endoscopy (220kg 170cm). We used Mayo tube in 4 patients.

Summary: number of endoscopic interventions performed in propofol narcosis is increasing. Propofol is safe; dose can be easily adjusted so the consequences of over- or undersedation can be eliminated. Propofol decreases the time of monitoring necessary after the intervention, so the performance of the endoscopic laboratory can be increased.