Pulmonologist-Administered Balanced Propofol Analgosedation during Interventional Procedures: An Italian Real-Life Study on Comfort and Safety.
Journal
International journal of clinical practice
ISSN: 1742-1241
Titre abrégé: Int J Clin Pract
Pays: India
ID NLM: 9712381
Informations de publication
Date de publication:
2022
2022
Historique:
received:
21
01
2022
revised:
17
05
2022
accepted:
25
05
2022
entrez:
11
7
2022
pubmed:
12
7
2022
medline:
14
7
2022
Statut:
epublish
Résumé
Propofol-based sedation provides faster recovery than midazolam-based regimens with similar safety and comfort during video flexible bronchoscope (VFB) procedures. Pulmonologist-administered propofol "balanced" analgosedation (PAP-BAS) is still debated in Italy. In this real-life study, PAP-BAS safety and comfort during VFB procedures were investigated. We analysed prospectively the subjects undergoing elective VFB procedures in the Pulmonology and RICU of Arezzo Hospital between February and July 2019. PAP-BAS combined low propofol and meperidine doses titrated to achieve an RASS score between 0 and -3. The primary end-point was the complications' rate. Secondary end-points were as follows: the relation between propofol's dose and a subject's comfort assessed with a VAS, recovery time according to a modified Aldrete score ≥9, RASS, and subjects' will of undergoing the procedure again. We collected postprocedure symptoms' intensity too. Our 158 study patients (67 years; SD ± 14; 64% males) incurred in 25% of complication, fully resolved with medical therapy. Neither recourse to ventilator support nor death was reported. Intraprocedural comfort was good (94% of VAS score ≤2). Among postprocedural symptoms, cough was the most frequently reported, in 36% of the cases. Although half of subjects remembered the procedure, 90% of them would have repeated it, if necessary. 85% of them recovered from procedures within 10 minutes. Complications, VAS, and recovery time were not correlated with propofol dose. To our knowledge, this is the first Italian study showing that PAP-BAS to perform a VFB procedure is safe, well tolerated with a quick recovery. Randomised controlled trials are warranted to confirm these preliminary results.
Identifiants
pubmed: 35814307
doi: 10.1155/2022/3368077
pmc: PMC9208941
doi:
Substances chimiques
Hypnotics and Sedatives
0
Meperidine
9E338QE28F
Midazolam
R60L0SM5BC
Propofol
YI7VU623SF
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
3368077Informations de copyright
Copyright © 2022 Rosalba Maffucci et al.
Déclaration de conflit d'intérêts
The authors declare that there are no conflicts of interest regarding the publication of this article.
Références
Acta Anaesthesiol Scand. 2005 Oct;49(9):1334-8
pubmed: 16146472
Swiss Med Wkly. 2011 Aug 26;141:w13248
pubmed: 21870301
Chest. 2011 Nov;140(5):1342-1350
pubmed: 22045879
Gastrointest Endosc. 2009 Dec;70(6):1053-9
pubmed: 19962497
Respiration. 2021;100(10):1027-1037
pubmed: 34102641
PLoS One. 2017 Apr 12;12(4):e0175394
pubmed: 28403208
Jpn J Clin Oncol. 2016 Sep;46(9):871-4
pubmed: 27380809
Medicine (Baltimore). 2018 Sep;97(36):e12229
pubmed: 30200147
Curr Opin Anaesthesiol. 2017 Aug;30(4):490-495
pubmed: 28509771
Anasthesiol Intensivmed Notfallmed Schmerzther. 2004 Oct;39(10):597-602
pubmed: 15486802
Thorax. 2011 Nov;66 Suppl 3:iii1-21
pubmed: 21987439
Exp Ther Med. 2015 Aug;10(2):659-664
pubmed: 26622371
Int J Evid Based Healthc. 2013 Dec;11(4):275-84
pubmed: 24298921
Clin Respir J. 2017 Nov;11(6):935-941
pubmed: 26720178
Thorax. 2001 Mar;56 Suppl 1:i1-21
pubmed: 11158709
Endoscopy. 2012 May;44(5):504-11
pubmed: 22389232
Pulm Med. 2015;2015:727530
pubmed: 26543645
Eur Respir J. 2009 Nov;34(5):1024-30
pubmed: 19386684
Respir Care. 2007 Jan;52(1):26-30
pubmed: 17194314
Panminerva Med. 2016 Sep;58(3):211-21
pubmed: 27012292
J Clin Anesth. 1995 Feb;7(1):89-91
pubmed: 7772368
Ann Am Thorac Soc. 2013 Apr;10(2):121-6
pubmed: 23607840
Arch Bronconeumol. 2017 Sep;53(9):489-494
pubmed: 28410767
Monaldi Arch Chest Dis. 2017 Jul 18;87(2):768
pubmed: 28967732
Eur Respir J. 2009 Dec;34(6):1277-83
pubmed: 19443532
PLoS One. 2011;6(11):e27769
pubmed: 22132138
Respir Care. 2011 Aug;56(8):1100-7
pubmed: 21496373
Lancet. 1974 Nov 9;2(7889):1127-31
pubmed: 4139420
Respiration. 2011;82(6):515-21
pubmed: 21934290
Am J Respir Crit Care Med. 2002 Nov 15;166(10):1338-44
pubmed: 12421743
Am J Respir Crit Care Med. 2015 Apr 1;191(7):796-803
pubmed: 25574801