Pre-endoscopic tachycardia predicts increased sedation dose and lower adenoma detection rate in patients undergoing endoscopic procedures: a case control study.
Adenoma
/ diagnostic imaging
Adult
Aged
Anxiety
/ drug therapy
Case-Control Studies
Colonoscopy
/ psychology
Endoscopy, Gastrointestinal
/ psychology
Female
Fentanyl
/ administration & dosage
Gastrointestinal Neoplasms
/ diagnostic imaging
Gastroscopy
/ psychology
Heart Rate
Humans
Hypnotics and Sedatives
/ administration & dosage
Male
Midazolam
/ administration & dosage
Middle Aged
Preoperative Period
Propofol
/ administration & dosage
Retrospective Studies
Tachycardia
/ epidemiology
Journal
Minerva medica
ISSN: 1827-1669
Titre abrégé: Minerva Med
Pays: Italy
ID NLM: 0400732
Informations de publication
Date de publication:
Apr 2020
Apr 2020
Historique:
pubmed:
14
3
2020
medline:
15
5
2020
entrez:
14
3
2020
Statut:
ppublish
Résumé
Tachycardia prior to endoscopic procedures is commonly encountered which reflect patient anxiety status. Despite this frequent occurrence, it is unclear if in a patient with tachycardia sedation dose should be modified. The aim of our study was to assess the effect of pre-endoscopic tachycardia on sedation dose. A retrospective analysis of all patients who underwent upper endoscopy and colonoscopy at EMMS Nazareth hospital were performed. We excluded patients with diseases and medications affecting the heart rate. A total of 2855 patients were included in the study. Two-hundred and thirty-seven patients had tachycardia before endoscopy (8.3%, group A) as compared to 2618 (group B) patients who had heart rate ≤100 beats per minute. The mean dosage of propofol in group A was significantly higher (62.6±33.2 mg vs. 57.4±29.9 mg) than in group B (P=0.01). There was no difference in the cecal intubation rate among the two groups (P=0.9). Notably, the adenoma detection rate was significantly lower among group A patients as compared to group B (13.6% vs. 22.8%, P=0.02) patients. There were no sedation related complications. Tachycardia prior to endoscopic procedures was associated with higher sedative dosage and lower adenoma detection rate, however no major complications were recorded. These data should be taken into consideration to optimize procedure quality.
Sections du résumé
BACKGROUND
BACKGROUND
Tachycardia prior to endoscopic procedures is commonly encountered which reflect patient anxiety status. Despite this frequent occurrence, it is unclear if in a patient with tachycardia sedation dose should be modified. The aim of our study was to assess the effect of pre-endoscopic tachycardia on sedation dose.
METHODS
METHODS
A retrospective analysis of all patients who underwent upper endoscopy and colonoscopy at EMMS Nazareth hospital were performed. We excluded patients with diseases and medications affecting the heart rate.
RESULTS
RESULTS
A total of 2855 patients were included in the study. Two-hundred and thirty-seven patients had tachycardia before endoscopy (8.3%, group A) as compared to 2618 (group B) patients who had heart rate ≤100 beats per minute. The mean dosage of propofol in group A was significantly higher (62.6±33.2 mg vs. 57.4±29.9 mg) than in group B (P=0.01). There was no difference in the cecal intubation rate among the two groups (P=0.9). Notably, the adenoma detection rate was significantly lower among group A patients as compared to group B (13.6% vs. 22.8%, P=0.02) patients. There were no sedation related complications.
CONCLUSIONS
CONCLUSIONS
Tachycardia prior to endoscopic procedures was associated with higher sedative dosage and lower adenoma detection rate, however no major complications were recorded. These data should be taken into consideration to optimize procedure quality.
Identifiants
pubmed: 32166934
pii: S0026-4806.20.06468-X
doi: 10.23736/S0026-4806.20.06468-X
doi:
Substances chimiques
Hypnotics and Sedatives
0
Midazolam
R60L0SM5BC
Fentanyl
UF599785JZ
Propofol
YI7VU623SF
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM