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Continuous infusion versus intermittent bolus injection of propofol during endoscopic retrograde cholangiopancreatography

Korean Journal of Internal Medicine 2020년 35권 6호 p.1338 ~ 1345
이재곤, 유교상, 변영재,
소속 상세정보
이재곤 ( Lee Jae-Gon ) - Hanyang University Guri Hospital Department of Internal Medicine
유교상 ( Yoo Kyo-Sang ) - Hanyang University Guri Hospital Department of Internal Medicine
변영재 ( Byun Young-Jae ) - Hanyang University Guri Hospital Department of Internal Medicine

Abstract


Background/Aims: It is unclear whether continuous infusion or intermittent bolus injection of propofol is better for achieving adequate sedation in endoscopic retrograde cholangiopancreatography (ERCP). We aimed to compare the efficacy and safety of continuous infusion and intermittent bolus injection of propofol during therapeutic ERCP.

Methods: In this prospective study, we randomly assigned 232 patients undergoing therapeutic ERCP to either continuous infusion (CI group, n = 113) or intermittent bolus injection (BI group, n = 119) of propofol. The primary outcome was the quality of sedation as assessed by the endoscopist. Other sedation-related parameters included sedation induction time, total dose of propofol, recovery time, involuntary patient movement, and adverse events.

Results: Overall satisfaction with sedation by the endoscopist and monitoring nurse were significantly higher in the CI group than the BI group (mean satisfaction score, 9.66 vs. 8.0 and 9.47 vs. 7.96, respectively, p < 0.01 for both). However, patients in the CI group had a significantly longer sedation induction time (5.28 minutes vs. 4.34 minutes, p < 0.01) and received a higher dose of propofol than patients in the BI group (4.22 mg/kg vs. 2.08 mg/kg, p < 0.01). There was no significant difference in adverse events between the two groups.

Conclusions: Continuous infusion of propofol during therapeutic ERCP had the advantage over intermittent bolus injection of maintaining a constant level of sedation without increasing adverse events. However, it was associated with an increased total dose of propofol and prolonged sedation induction time.

키워드

Propofol; Deep sedation; Endoscopic retrograde cholangiopancreatography

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