Safety and Effectiveness of Endoscopist-Directed Nurse-Administered Sedation during Gastric Endoscopic Submucosal Dissection
Background and Aims. Endoscopic submucosal dissection (ESD) is routinely performed in treating gastric neoplasia and requires long-term higher levels of sedation. Endoscopist-directed nurse-administered sedation (EDNAS) has not been well studied in ESD. This study aimed to evaluate the safety and ef...
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| Format: | Article |
| Language: | English |
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Wiley
2017-01-01
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| Series: | Gastroenterology Research and Practice |
| Online Access: | http://dx.doi.org/10.1155/2017/4723626 |
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| author | Yong Suk Cho Sang youn Shin Changhyeok Hwang Jeonghun Seo Jong Won Choi Byung Kyu Park Sun Young Won Chun Kyon Lee Yong Kang Lee Han Ho Jeon |
| author_facet | Yong Suk Cho Sang youn Shin Changhyeok Hwang Jeonghun Seo Jong Won Choi Byung Kyu Park Sun Young Won Chun Kyon Lee Yong Kang Lee Han Ho Jeon |
| author_sort | Yong Suk Cho |
| collection | DOAJ |
| description | Background and Aims. Endoscopic submucosal dissection (ESD) is routinely performed in treating gastric neoplasia and requires long-term higher levels of sedation. Endoscopist-directed nurse-administered sedation (EDNAS) has not been well studied in ESD. This study aimed to evaluate the safety and effectiveness of EDNAS for ESD. Methods. Patients treated with ESD for gastric tumors between 2013 and 2015 were retrospectively collected. Patients were divided into a midazolam-treated group (M group) and a midazolam plus propofol-treated group (MP group). Clinical outcome, safety, effectiveness, adverse events of ESD, and adverse events of sedation were analyzed. Results. Of 209 collected patients, 83 were in the M group and 126 were in the MP group. Of all patients, 67 patients had the circulatory adverse event during the ESD procedure. Sedation method was the only significant risk factor (M versus MP: 2.17 (1.14–4.15), p=0.019). In analysis of MP subgroups, 47 patients suffered an adverse event from sedation, and current smoking was the only significant association factor for adverse event (0.15 (0.03–0.68), p=0.014). Conclusions. In performing ESD, the effect of sedation is reduced in smoking patients. EDNAS may be acceptable for ESD under careful monitoring of vital sign and oxygen saturation. |
| format | Article |
| id | doaj-art-3eb060f9e6b44bf3bb9c9e51e2169ef8 |
| institution | Kabale University |
| issn | 1687-6121 1687-630X |
| language | English |
| publishDate | 2017-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Gastroenterology Research and Practice |
| spelling | doaj-art-3eb060f9e6b44bf3bb9c9e51e2169ef82025-02-03T06:00:30ZengWileyGastroenterology Research and Practice1687-61211687-630X2017-01-01201710.1155/2017/47236264723626Safety and Effectiveness of Endoscopist-Directed Nurse-Administered Sedation during Gastric Endoscopic Submucosal DissectionYong Suk Cho0Sang youn Shin1Changhyeok Hwang2Jeonghun Seo3Jong Won Choi4Byung Kyu Park5Sun Young Won6Chun Kyon Lee7Yong Kang Lee8Han Ho Jeon9Division of Gastroenterology, Department of Internal Medicine, National Health Insurance Service Ilsan Hospital, Ilsan, Republic of KoreaDivision of Gastroenterology, Department of Internal Medicine, National Health Insurance Service Ilsan Hospital, Ilsan, Republic of KoreaDivision of Gastroenterology, Department of Internal Medicine, National Health Insurance Service Ilsan Hospital, Ilsan, Republic of KoreaDivision of Gastroenterology, Department of Internal Medicine, National Health Insurance Service Ilsan Hospital, Ilsan, Republic of KoreaDivision of Gastroenterology, Department of Internal Medicine, National Health Insurance Service Ilsan Hospital, Ilsan, Republic of KoreaDivision of Gastroenterology, Department of Internal Medicine, National Health Insurance Service Ilsan Hospital, Ilsan, Republic of KoreaDivision of Gastroenterology, Department of Internal Medicine, National Health Insurance Service Ilsan Hospital, Ilsan, Republic of KoreaDivision of Gastroenterology, Department of Internal Medicine, National Health Insurance Service Ilsan Hospital, Ilsan, Republic of KoreaDivision of Gastroenterology, Department of Internal Medicine, National Health Insurance Service Ilsan Hospital, Ilsan, Republic of KoreaDivision of Gastroenterology, Department of Internal Medicine, National Health Insurance Service Ilsan Hospital, Ilsan, Republic of KoreaBackground and Aims. Endoscopic submucosal dissection (ESD) is routinely performed in treating gastric neoplasia and requires long-term higher levels of sedation. Endoscopist-directed nurse-administered sedation (EDNAS) has not been well studied in ESD. This study aimed to evaluate the safety and effectiveness of EDNAS for ESD. Methods. Patients treated with ESD for gastric tumors between 2013 and 2015 were retrospectively collected. Patients were divided into a midazolam-treated group (M group) and a midazolam plus propofol-treated group (MP group). Clinical outcome, safety, effectiveness, adverse events of ESD, and adverse events of sedation were analyzed. Results. Of 209 collected patients, 83 were in the M group and 126 were in the MP group. Of all patients, 67 patients had the circulatory adverse event during the ESD procedure. Sedation method was the only significant risk factor (M versus MP: 2.17 (1.14–4.15), p=0.019). In analysis of MP subgroups, 47 patients suffered an adverse event from sedation, and current smoking was the only significant association factor for adverse event (0.15 (0.03–0.68), p=0.014). Conclusions. In performing ESD, the effect of sedation is reduced in smoking patients. EDNAS may be acceptable for ESD under careful monitoring of vital sign and oxygen saturation.http://dx.doi.org/10.1155/2017/4723626 |
| spellingShingle | Yong Suk Cho Sang youn Shin Changhyeok Hwang Jeonghun Seo Jong Won Choi Byung Kyu Park Sun Young Won Chun Kyon Lee Yong Kang Lee Han Ho Jeon Safety and Effectiveness of Endoscopist-Directed Nurse-Administered Sedation during Gastric Endoscopic Submucosal Dissection Gastroenterology Research and Practice |
| title | Safety and Effectiveness of Endoscopist-Directed Nurse-Administered Sedation during Gastric Endoscopic Submucosal Dissection |
| title_full | Safety and Effectiveness of Endoscopist-Directed Nurse-Administered Sedation during Gastric Endoscopic Submucosal Dissection |
| title_fullStr | Safety and Effectiveness of Endoscopist-Directed Nurse-Administered Sedation during Gastric Endoscopic Submucosal Dissection |
| title_full_unstemmed | Safety and Effectiveness of Endoscopist-Directed Nurse-Administered Sedation during Gastric Endoscopic Submucosal Dissection |
| title_short | Safety and Effectiveness of Endoscopist-Directed Nurse-Administered Sedation during Gastric Endoscopic Submucosal Dissection |
| title_sort | safety and effectiveness of endoscopist directed nurse administered sedation during gastric endoscopic submucosal dissection |
| url | http://dx.doi.org/10.1155/2017/4723626 |
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