Dilatation Therapy and Demographic Characteristics Significantly Influence the Amount of Propofol for Therapeutic Endoscopic Retrograde Cholangiography

Schmidt, Christoph A.; Keil, Carsten; Kirstein, Martha M.; Lehner, Frank ORCID; Manns, Michael Peter; von Hahn, Thomas ORCID; Lankisch, Tim O.; Voigtländer, Torsten ORCID

Background and Study Aims: Patients undergoing therapeutic endoscopic retrograde cholangiography (ERC) may require different amounts of sedative agents depending on demographic characteristics, indication of ERC, and/or endoscopic intervention. Patients and Methods: We retrospectively analyzed all patients undergoing therapeutic ERC from 2008 - 2014 who received deep sedation with propofol +/- midazolam. Results: A total of 2448 ERC procedures were performed in 781 patients. The cumulative per procedure propofol dose in the different groups was as follows: PSC 479 mg (+/-256), bile duct stones 356 mg (+/-187), benign stenosis/cholestasis 395 mg (+/-228), malignant stenosis 401 mg (+/-283), and postliver transplant complications 391 mg (+/-223) (p < 0.05). Multivariable analysis showed that dilatation therapy (p = 0.001), age (p = 0.001), duration of the intervention (p = 0.001), BMI (p = 0.001), gender (p = 0.001), platelet count (p = 0.003), and bilirubin (p = 0.043) influence independently the propofol consumption. Conclusions: Demographic characteristics and endoscopic interventions have a distinct influence on the amount of sedation required for therapeutic ERC. Although the sedation-associated complication rate is low optimization of sedative regimens is a prime goal to further reduce adverse events of therapeutic ERC

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Schmidt, Christoph / Keil, Carsten / Kirstein, Martha / et al: Dilatation Therapy and Demographic Characteristics Significantly Influence the Amount of Propofol for Therapeutic Endoscopic Retrograde Cholangiography. 2019.

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