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Original Article
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Korean J Med. 2008;75(5):546-552.
- 원저: 대상성 간경변증 환자의 수면내시경을 위한 Propofol의 안전성과 유용성
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윤효중.김상균.나현식.맹주희.한상훈.장재영.고봉민.홍수진.유창범.김영석.문종호.이준성.이문, , , , , , , , , , , , , ,
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- Safety and efficacy of propofol for sedative endoscopy in patients with compensated liver cirrhosis
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Hyo Joong Yoon, Sang Gyune Kim, Hyun Sik Na, Ju Hee Maeng, Sang Hoon Han, Jae Young Jang, Bong Min Ko, Su Jin Hong, Chang Beom Ryu, Young Soek Kim, Jong Ho Moon, Joon Seong Lee, Moon Sung Lee, Chan Sup Shim, Boo Sung Kim
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Lung and Esophageal Cancer Clinic1, Department of internal medicine2, Chonnam National University Medical School
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- Abstract
- Background/Aims: Propofol is widely used for sedation during endoscopy. Because propofol may cause hepatic encephalopathy, hemodynamic compromise, and respiratory depression, cautious use is required in patients with liver cirrhosis. We evaluated the safety and efficacy of propofol in compensated cirrhosis during endoscopic examination.
Methods: Thirty-nine cirrhotic patients (19 and 20 cases of Child Pugh classes A and B, respectively) and 56 control subjects were included. The initial dose of propofol (40 mg) was increased by 20-mg increments until moderate sedation was achieved. The number connection test, flapping tremor test, blood pressure, heart rate, oxygen saturation, liver enzymes, and prothrombin time were evaluated before and after endoscopy.
Results: No significant change was observed in any parameter compared to baseline in either group. The mean dose of propofol was significantly lower in cirrhotic versus control subjects (49.7¡¾15.8 versus 65.0¡¾17.9 mg, respectively; p<0.001). Scores based on a visual analog scale evaluating patient satisfaction did not differ between groups (72¡¾27 versus 64¡¾26, respectively; p=0.196), nor did mean recovery time (16.4¡¾9.8 versus 14.2¡¾6.7 min, respectively; p=0.186).
Conclusion: Propofol is safe and effective for moderate sedation in compensated liver cirrhosis. (Korean J Med 75:546-552, 2008)
Keywords :Cirrhosis, Propofol, Sedation for endoscopy
