Anesthetic Trainee-Administered Propofol Deep Sedation for Small Bowel Enteroscopy Procedure in Elderly Patients

Abstract

AIM: To compare and evaluate the clinical efficacy of anesthetic trainee-administered propofol deep sedation (PDS) by using a syringe pump for small bowel enteroscopy (SBE) procedure between patients aged<65 years and patients aged≥65 years in an endoscopic unit outside operating room in Thailand. METHODS: We undertook a retrospective review of SBE procedures. Patients were classified into two groups: group A (age < 65 years) and group B (age ≥65 years). The primary outcome variable of the study was the successful completion of procedure. Secondary outcome variables were sedation-related complications during and immediately after the procedure. RESULTS: After matching the patients’ characteristics, duration and indications of procedure, there were 45 patients in group A and 28 patients in group B. There were no significant differences in characteristics of patients, duration of procedure and indications of procedure between the two groups. All sedations were used successfully except one patient in group A. There were no significant differences in overall, respiratory and cardiovascular-related complications between the two groups. However, hypotension in group B was significantly higher than in group A. CONCLUSION: In the setting of endoscopy unit outside operating room, PDS by anesthetic trainee using a syringe pump for SBE procedure in elderly patients with appropriate monitoring was relatively safe and effective. Clinical efficacy of this technique in elderly patients was not different or worse than in younger patients. However, the rate of hypotension was significantly high in the elderly patients than younger patients. Serious complications were rare.