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Computer-assisted personalized sedation for upper endoscopy and colonoscopy: a comparative, multicenter randomized study

医学 结肠镜检查 镇静 内窥镜检查 随机对照试验 多中心研究 上内镜检查 外科 内科学 结直肠癌 癌症
作者
Daniel J. Pambianco,John J. Vargo,Ronald E. Pruitt,Robert Hardi,James F. Martin
出处
期刊:Gastrointestinal Endoscopy [Elsevier BV]
卷期号:73 (4): 765-772 被引量:127
标识
DOI:10.1016/j.gie.2010.10.031
摘要

The SEDASYS System is an investigational computer-assisted personalized sedation system integrating propofol delivery with patient monitoring to enable endoscopist/nurse teams to safely administer propofol.To compare the safety and effectiveness of the SEDASYS System to the current standard of care for sedation during routine endoscopic procedures.Nonblinded multicenter randomized comparative study.Four ambulatory surgery centers, 3 endoscopy centers, and 1 academic center in the United States.One thousand American Society of Anesthesiologists physical status class I to III adults undergoing routine colonoscopy or EGD.Sedation with the SEDASYS System (SED) and sedation with each site's current standard of care (CSC; benzodiazepine/opioid combination).Area under the curve of oxygen desaturation was the primary endpoint. Secondary endpoints included patient satisfaction, clinician satisfaction, level of sedation, and patient recovery time.Four hundred ninety-six patients were randomized to SED and 504 to CSC. Area under the curve of oxygen desaturation was significantly lower for SED (23.6 s·%) than for CSC (88.0 s·%; P = .028). Patients were predominately minimally to moderately sedated in both groups. SED patients were significantly more satisfied than CSC patients (P = .007). Clinician satisfaction was greater with SED than with CSC (P < .001). SED patients recovered faster than CSC patients (P < .001). The incidence of adverse events was 5.8% in the SED group and 8.7% in the CSC group.Nonblinded.The SEDASYS System could provide endoscopist/nurse teams a safe and effective on-label means to administer propofol to effect minimal to moderate sedation during routine colonoscopy and EGD.

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