Cureus · 2026
Safety and Recovery Profile of Propofol-Based Intravenous Sedation for Endoscopic Retrograde Cholangiopancreatography in Adults: A Prospective Single-Center Observational Study.
СтатьяНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
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Khan Muhammad Ahmad, Mahmood Tariq, Baig Mirza Ahmad Raza, Noor Hafsa, Ahmed Heba Ahmed Aboelfetooh
Аннотация
BACKGROUND: Endoscopic retrograde cholangiopancreatography (ERCP) frequently requires deep sedation, but prone positioning, restricted airway access, and variable procedural duration create important safety concerns. We evaluated respiratory and hemodynamic events, recovery, and satisfaction during propofol-based intravenous sedation.
METHODS: This prospective, single-center observational study included 100 adults with American Society of Anesthesiologists physical status I or II who underwent elective ERCP for common bile duct stones at King Khalid Hospital in Saudi Arabia from June 2025 to June 2026. Patients received midazolam 2 mg and fentanyl 1 µg/kg intravenously, followed by a propofol infusion of 30-50 µg/kg/minute and 20-30 mg boluses as needed. Patients were prone and received oxygen at 3 L/min through a nasal cannula with an incorporated carbon dioxide sampling line. Standard variables were recorded every five minutes, with continuous waveform capnography. Exact binomial 95% confidence intervals (CIs) were calculated for adverse-event proportions, and Spearman correlation assessed associations with propofol bolus count.
RESULTS: The mean age was 35.1 ± 7.2 years, 53 (53%) were female patients, and 73 (73%) had physical status I. The mean procedure duration was 65.3 ± 12.7 minutes. No oxygen desaturation or tracheal intubation occurred (0/100 (0%); 95% CI, 0-3.6 for each). Airway maneuvers and procedural interruption occurred in the same five patients (5/100 (5%); 95% CI, 1.6-11.3), and postoperative nausea and vomiting (PONV) occurred in four patients (4/100 (4%); 95% CI, 1.1-9.9). Median recovery time was five minutes (interquartile range (IQR), 5-6), and median recovery-room stay was 20 minutes (IQR, 20-20). Mean patient and endoscopist satisfaction scores were 9.63 ± 0.71 and 9.65 ± 0.77, respectively. Longer procedures were associated with more propofol boluses (Spearman ρ = 0.448; p < 0.001), whereas bolus count was not associated with recovery time (ρ = 0.123; p = 0.225).
CONCLUSION: In this selected, low-risk cohort, propofol-based intravenous sedation with nasal waveform capnography was associated with no recorded hypoxemia or intubation, infrequent airway intervention and PONV, rapid recovery, and high satisfaction. Larger comparative studies using standardized respiratory definitions and prospectively defined capnographic outcomes are warranted.
METHODS: This prospective, single-center observational study included 100 adults with American Society of Anesthesiologists physical status I or II who underwent elective ERCP for common bile duct stones at King Khalid Hospital in Saudi Arabia from June 2025 to June 2026. Patients received midazolam 2 mg and fentanyl 1 µg/kg intravenously, followed by a propofol infusion of 30-50 µg/kg/minute and 20-30 mg boluses as needed. Patients were prone and received oxygen at 3 L/min through a nasal cannula with an incorporated carbon dioxide sampling line. Standard variables were recorded every five minutes, with continuous waveform capnography. Exact binomial 95% confidence intervals (CIs) were calculated for adverse-event proportions, and Spearman correlation assessed associations with propofol bolus count.
RESULTS: The mean age was 35.1 ± 7.2 years, 53 (53%) were female patients, and 73 (73%) had physical status I. The mean procedure duration was 65.3 ± 12.7 minutes. No oxygen desaturation or tracheal intubation occurred (0/100 (0%); 95% CI, 0-3.6 for each). Airway maneuvers and procedural interruption occurred in the same five patients (5/100 (5%); 95% CI, 1.6-11.3), and postoperative nausea and vomiting (PONV) occurred in four patients (4/100 (4%); 95% CI, 1.1-9.9). Median recovery time was five minutes (interquartile range (IQR), 5-6), and median recovery-room stay was 20 minutes (IQR, 20-20). Mean patient and endoscopist satisfaction scores were 9.63 ± 0.71 and 9.65 ± 0.77, respectively. Longer procedures were associated with more propofol boluses (Spearman ρ = 0.448; p < 0.001), whereas bolus count was not associated with recovery time (ρ = 0.123; p = 0.225).
CONCLUSION: In this selected, low-risk cohort, propofol-based intravenous sedation with nasal waveform capnography was associated with no recorded hypoxemia or intubation, infrequent airway intervention and PONV, rapid recovery, and high satisfaction. Larger comparative studies using standardized respiratory definitions and prospectively defined capnographic outcomes are warranted.