Nurse-administered propofol sedation compared with midazolam and meperidine for EUS: a prospective, randomized trial

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Abstract

Background: The utility of nurse-administered propofol sedation (NAPS) compared with midazolam and meperidine (M/M) for EUS is not known. Objective: To compare recovery times, costs, safety, health personnel, and patient satisfaction of NAPS and M/M for EUS. Design: Prospective, randomized, single-blinded trial. Setting: Tertiary-referral hospital in Indianapolis, Indiana. Patients: Outpatients referred for EUS. Interventions: Sedation with M/M or NAPS. The patient and recovery nurse were blinded; however, the sedating nurse, endoscopist, and recording research nurse were unblinded to the sedatives used. A capnography, in addition to standard monitoring, was used. A questionnaire and visual analog scale assessed patient, endoscopist, and sedating nurse satisfaction. Main Outcome Measurements: Recovery times, costs, safety, health personnel, and patient satisfaction in both groups. Results: Eighty consecutive patients were randomized to NAPS (n = 40) or M/M (n = 40). More patients in the propofol group were current tobacco users; patient demographics, procedures performed, mean procedure length, and the overall frequency of adverse events were otherwise similar. Compared with M/M, NAPS was associated with a faster induction of sedation (2.3 vs 5.7 minutes, respectively; P = .001) and full recovery time (29 vs 49 minutes, respectively; P = .001), higher postprocedure patient satisfaction, and quicker anticipated return to baseline function. At discharge, total costs (recovery plus medications) were similar between the propofol ($406) and M/M groups ($399; P = .79). Limitation: Low-risk patient population. Conclusions: Compared with M/M, NAPS for an EUS offered a faster sedation induction and full recovery time, higher postprocedure patient satisfaction, and a quicker anticipated return to baseline function. Total costs were similar between the groups.

Original languageEnglish
Pages (from-to)499-509
Number of pages11
JournalGastrointestinal Endoscopy
Volume68
Issue number3
DOIs
StatePublished - Sep 2008

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Meperidine
Midazolam
Propofol
Nurses
Patient Satisfaction
Costs and Cost Analysis
Health Personnel
Capnography
Safety
Hypnotics and Sedatives
Visual Analog Scale
Tertiary Care Centers
Tobacco
Outpatients
Demography

ASJC Scopus subject areas

  • Gastroenterology

Cite this

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title = "Nurse-administered propofol sedation compared with midazolam and meperidine for EUS: a prospective, randomized trial",
abstract = "Background: The utility of nurse-administered propofol sedation (NAPS) compared with midazolam and meperidine (M/M) for EUS is not known. Objective: To compare recovery times, costs, safety, health personnel, and patient satisfaction of NAPS and M/M for EUS. Design: Prospective, randomized, single-blinded trial. Setting: Tertiary-referral hospital in Indianapolis, Indiana. Patients: Outpatients referred for EUS. Interventions: Sedation with M/M or NAPS. The patient and recovery nurse were blinded; however, the sedating nurse, endoscopist, and recording research nurse were unblinded to the sedatives used. A capnography, in addition to standard monitoring, was used. A questionnaire and visual analog scale assessed patient, endoscopist, and sedating nurse satisfaction. Main Outcome Measurements: Recovery times, costs, safety, health personnel, and patient satisfaction in both groups. Results: Eighty consecutive patients were randomized to NAPS (n = 40) or M/M (n = 40). More patients in the propofol group were current tobacco users; patient demographics, procedures performed, mean procedure length, and the overall frequency of adverse events were otherwise similar. Compared with M/M, NAPS was associated with a faster induction of sedation (2.3 vs 5.7 minutes, respectively; P = .001) and full recovery time (29 vs 49 minutes, respectively; P = .001), higher postprocedure patient satisfaction, and quicker anticipated return to baseline function. At discharge, total costs (recovery plus medications) were similar between the propofol ($406) and M/M groups ($399; P = .79). Limitation: Low-risk patient population. Conclusions: Compared with M/M, NAPS for an EUS offered a faster sedation induction and full recovery time, higher postprocedure patient satisfaction, and a quicker anticipated return to baseline function. Total costs were similar between the groups.",
author = "John DeWitt and Kathleen McGreevy and Stuart Sherman and Thomas Imperiale",
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T1 - Nurse-administered propofol sedation compared with midazolam and meperidine for EUS

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AU - DeWitt, John

AU - McGreevy, Kathleen

AU - Sherman, Stuart

AU - Imperiale, Thomas

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N2 - Background: The utility of nurse-administered propofol sedation (NAPS) compared with midazolam and meperidine (M/M) for EUS is not known. Objective: To compare recovery times, costs, safety, health personnel, and patient satisfaction of NAPS and M/M for EUS. Design: Prospective, randomized, single-blinded trial. Setting: Tertiary-referral hospital in Indianapolis, Indiana. Patients: Outpatients referred for EUS. Interventions: Sedation with M/M or NAPS. The patient and recovery nurse were blinded; however, the sedating nurse, endoscopist, and recording research nurse were unblinded to the sedatives used. A capnography, in addition to standard monitoring, was used. A questionnaire and visual analog scale assessed patient, endoscopist, and sedating nurse satisfaction. Main Outcome Measurements: Recovery times, costs, safety, health personnel, and patient satisfaction in both groups. Results: Eighty consecutive patients were randomized to NAPS (n = 40) or M/M (n = 40). More patients in the propofol group were current tobacco users; patient demographics, procedures performed, mean procedure length, and the overall frequency of adverse events were otherwise similar. Compared with M/M, NAPS was associated with a faster induction of sedation (2.3 vs 5.7 minutes, respectively; P = .001) and full recovery time (29 vs 49 minutes, respectively; P = .001), higher postprocedure patient satisfaction, and quicker anticipated return to baseline function. At discharge, total costs (recovery plus medications) were similar between the propofol ($406) and M/M groups ($399; P = .79). Limitation: Low-risk patient population. Conclusions: Compared with M/M, NAPS for an EUS offered a faster sedation induction and full recovery time, higher postprocedure patient satisfaction, and a quicker anticipated return to baseline function. Total costs were similar between the groups.

AB - Background: The utility of nurse-administered propofol sedation (NAPS) compared with midazolam and meperidine (M/M) for EUS is not known. Objective: To compare recovery times, costs, safety, health personnel, and patient satisfaction of NAPS and M/M for EUS. Design: Prospective, randomized, single-blinded trial. Setting: Tertiary-referral hospital in Indianapolis, Indiana. Patients: Outpatients referred for EUS. Interventions: Sedation with M/M or NAPS. The patient and recovery nurse were blinded; however, the sedating nurse, endoscopist, and recording research nurse were unblinded to the sedatives used. A capnography, in addition to standard monitoring, was used. A questionnaire and visual analog scale assessed patient, endoscopist, and sedating nurse satisfaction. Main Outcome Measurements: Recovery times, costs, safety, health personnel, and patient satisfaction in both groups. Results: Eighty consecutive patients were randomized to NAPS (n = 40) or M/M (n = 40). More patients in the propofol group were current tobacco users; patient demographics, procedures performed, mean procedure length, and the overall frequency of adverse events were otherwise similar. Compared with M/M, NAPS was associated with a faster induction of sedation (2.3 vs 5.7 minutes, respectively; P = .001) and full recovery time (29 vs 49 minutes, respectively; P = .001), higher postprocedure patient satisfaction, and quicker anticipated return to baseline function. At discharge, total costs (recovery plus medications) were similar between the propofol ($406) and M/M groups ($399; P = .79). Limitation: Low-risk patient population. Conclusions: Compared with M/M, NAPS for an EUS offered a faster sedation induction and full recovery time, higher postprocedure patient satisfaction, and a quicker anticipated return to baseline function. Total costs were similar between the groups.

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