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Safety and effectiveness of propofol sedation during and after outpatient colonoscopy

World Journal of Gastroenterology 2012年第26期18卷 3420-3425页

作者： Akira Horiuchi Yoshiko Nakayama masashi kajiyama Naoyuki Kato Tetsuya Kamijima Yasuyuki Ichise Naoki Tanaka Digestive Disease Center Showa Inan General HospitalKomagane 399-4117Japan Department of Pediatrics Shinshu University School of MedicineMatsumoto 390-8621Japan Department of Metabolic Regulation Shinshu University Graduate School of MedicineMatsumoto 390-8621Japan

AIM:To study the safety and effectiveness of propofol sedation for outpatient ***:Propofol was given by bolus injection with an age-adjusted standard protocol consisting of 60 mg for patients < 70 years old,40 mg for patients age 70-89 years,and 20 mg for those ≥ 90 years,and additional injections of 20 mg propofol were given up to a maximum of 200 *** principal parameters were the occurrence of adverse events within 24 h after colonoscopy and overall satisfaction for this *** parameters included successful procedure,respiratory depression,and other ***:Consecutive patients were entered prospectively and all 2101 entered successfully completed outpatient *** mean dose of propofol used was 96.4 mg(range 40-200 mg).Younger patients required higher doses of propofol than older patients(20-40 years vs ≥ 61 years:115.3 ± 32 mg vs 89.7 ± 21 mg,P < 0.001).Transient supplemental oxygen supply was needed by five patients(0.2%);no other complications *** questionnaires were completed by 1820(87%) of 2101 patients and most rated their overall satisfaction as excellent(80%) or good(17%).The majority(65%) of patients drove home or to their office after their ***(99%) were willing to repeat the same *** incidents occurred within 24 h after ***:Propofol sedation using a dose < 200 mg proved both safe and practical for outpatient colonoscopy.

关键词：结肠镜异丙酚安全性检查门诊镇静标准协议不良反应

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Determination of the cut-off score of an endoscopic scoring method to predict whether elderly patients with dysphagia can eat pureed diets

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World Journal of Gastrointestinal Endoscopy 2016年第6期8卷 288-294页

作者： Torao Sakamoto Akira Horiuchi Toshiyuki Makino masashi kajiyama Naoki Tanaka Masamitsu Hyodo Department of Rehabilitation Showa Inan General Hospital Digestive Disease Center Showa Inan General Hospital Department of Otolaryngology Head and Neck Surgery Kochi Medical School

AIM: To identify the cut-off value for predicting the ability of elderly patients with dysphagia to swallow pureed diets using a new endoscopy scoring method. METHODS: Endoscopic swallowing evaluation of pureed diets were done in patients ≥ 65 years with dysphagia. The Hyodo-Komagane score for endoscopic swallowing evaluation is expressed as the sum(0-12) of four degrees(0-3) with four parameters:(1) salivary pooling in the vallecula and piriform sinuses;(2) the response of glottal closure reflex induced by touching the epiglottis with the endoscope;(3) the location of the bolus at the time of swallow onset assessed by "white-out" following swallowing of test jelly; and(4) pharyngeal clearance after swallowing of test jelly. We used receiver operating characteristic(ROC) curve analysis to retrospectively analyze the association between the total score and successful oral intake of pureed diets. RESULTS: One hundred and seventy-eight patients were enrolled including 113 men(63%), mean age 83 years(range, 66-98). One hundred and twenty-six patients(71%) were able to eat pureed diets during the observation period(mean ± SD, 19 ± 14 d). In ROC analysis, the cut-off value of the score for eating the pureed diets was 7(sensitivity = 0.98; specificity = 0.91).CONCLUSION: The Hyodo-Komagane endoscopic score is useful to predict the ability to eat pureed diets in elderly patients with dysphagia.

关键词： Dysphagia Endoscopy Pureed diets Percutaneous endoscopic gastrostomy

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门诊病人的有效性经皮的内视镜的 gastrostomy 代替使用 esophagogastroduodenoscopy 和 propofol 镇静

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World Journal of Gastrointestinal Endoscopy 2012年第2期4卷 45-49页

作者： Akira Horiuchi Yoshiko Nakayama masashi kajiyama Naoki Tanaka Digestive Disease Center Showa Inan General Hospital Komagane 399-4117 Matsumoto Japan Department of Pediatrics Shinshu University School of Medicine Matsumoto 390-8621 Japan Department of Metabolic Regulation Shinshu University Graduate School of Medicine Matsumoto 390-8621 Japan

AIM: To evaluate the effectiveness of outpatient percutaneous endoscopic gastrostomy (PEG) replacement using esophagogastroduodenoscopy (EGD) and propofol sedation. METHODS: We retrospectively assessed the outcome and complications of consecutive patients referred for PEG replacement which was performed using EGD under propofol sedation in the outpatient setting. The success rate, the mean dose of propofol, procedure time, EGD findings, discharge time from endoscopy unit, respiratory depression, and complications within 72 h of the procedure were evaluated. In a subset of these patients, the blood concentrations of propofol were ***: All 221 patients underwent successful PEG replacement. The mean dose of propofol was 34 mg (range, 20-60 mg) with a mean procedure time of 5.9 min (range, 3-8 min). Reflux esophagitis (12 patients), gastric ulcer (5), gastric neoplasm (2), and duodenal ulcer (1) were newly diagnosed at replacement. Discharge from endoscopy unit was possible in 100% of patients 45 min after the procedure. Only 3.6% (8) required transient supplemental oxygen. No complications occurred within 72 h of the procedure. During EGD the level of sedation and propofol blood concentrations after administration of propofol (30 mg) in these PEG patients corresponded to those of propofol (60 mg) in middle aged subjects (control).

关键词： Esophagogastroduodenoscopy Gastrostomy PEG Propofol

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