Sygeplejerskeadministreret propofolsedation i forbindelse med endoskopi

TY - JOUR

T1 - Sygeplejerskeadministreret propofolsedation i forbindelse med endoskopi

AU - Vilmann, Peter

AU - Hornslet, Pernille

AU - Simmons, Hanne

AU - Hammering, Anne

AU - Clementsen, Paul

N1 - Keywords: Adolescent; Adult; Aged; Anesthetics, Intravenous; Clinical Competence; Conscious Sedation; Education, Nursing, Continuing; Endoscopy, Gastrointestinal; Female; Humans; Hypnotics and Sedatives; Male; Middle Aged; Nurses; Outcome Assessment (Health Care); Propofol; Safety; Young Adult

PY - 2009

Y1 - 2009

N2 - INTRODUCTION: As an increasing number of therapeutic and diagnostic procedures are performed endoscopically, the demand for sufficient sedation during endoscopy is rising. Propofol sedation administered by nurses (NAPS) has gained increasing popularity. NAPS was introduced at Gentofte Hospital in September 2007 after structured training at Roque Valley Surgical Center in Medford, Oregon, USA. The aim of the present study is to present our results with NAPS. MATERIAL AND METHODS: Patients referred for endoscopy were monitored with regard to blood pressure, pulse oxymetry, electrocardiography and evaluation of their respiration during and after the procedure. RESULTS: A total of 229 patients (233 endoscopic procedures) were included (ASA I: 68 (29%), ASA II: 116 (50%), ASA III: 44 (19%), ASA IV: 1 (0.4%)). The median propofol administration was 330 mg (variance 100-1,700 mg). Hypoxia, defined as oxygen < 92%, was observed in 18 patients. The hypoxia lasted less than 30 seconds in eight patients and between 30-60 seconds in eight cases. Two patients had hypoxia for a period exceeding 60 seconds. Propofol administration was discontinued in all 18 cases and increased oxygen flow was administered via a nasal tube. Short lasting manual mask ventilation was instituted in five patients. No serious events related to sedation were seen. CONCLUSIONS: NAPS seem to be a suitable method for sedation in endoscopy and should be implemented in Denmark. However, proper training is required in collaboration with anaesthesiologists. Udgivelsesdato: 2009-May

AB - INTRODUCTION: As an increasing number of therapeutic and diagnostic procedures are performed endoscopically, the demand for sufficient sedation during endoscopy is rising. Propofol sedation administered by nurses (NAPS) has gained increasing popularity. NAPS was introduced at Gentofte Hospital in September 2007 after structured training at Roque Valley Surgical Center in Medford, Oregon, USA. The aim of the present study is to present our results with NAPS. MATERIAL AND METHODS: Patients referred for endoscopy were monitored with regard to blood pressure, pulse oxymetry, electrocardiography and evaluation of their respiration during and after the procedure. RESULTS: A total of 229 patients (233 endoscopic procedures) were included (ASA I: 68 (29%), ASA II: 116 (50%), ASA III: 44 (19%), ASA IV: 1 (0.4%)). The median propofol administration was 330 mg (variance 100-1,700 mg). Hypoxia, defined as oxygen < 92%, was observed in 18 patients. The hypoxia lasted less than 30 seconds in eight patients and between 30-60 seconds in eight cases. Two patients had hypoxia for a period exceeding 60 seconds. Propofol administration was discontinued in all 18 cases and increased oxygen flow was administered via a nasal tube. Short lasting manual mask ventilation was instituted in five patients. No serious events related to sedation were seen. CONCLUSIONS: NAPS seem to be a suitable method for sedation in endoscopy and should be implemented in Denmark. However, proper training is required in collaboration with anaesthesiologists. Udgivelsesdato: 2009-May

M3 - Tidsskriftartikel

C2 - 19486612

SN - 0041-5782

VL - 171

SP - 1840

EP - 1843

JO - Ugeskrift for læger

JF - Ugeskrift for læger

IS - 22

ER -