Is balanced propofol sedation safe in elderly patients over 90 years of age undergoing ERCP?

Aims Balanced propofol sedation (BPS) has currently been widely applied to many endoscopic procedures, and its safety and effectiveness have been proven through several studies. The use of BPS in Endoscopic retrograde cholangiopancreatography (ERCP) has become more common, but there is still a lack of evidence on its safety in elderly patients. The aim of this study is to investigate the safety of BPS used in ERCP in patients over 90 years

Methods This is a retrospective study of patients who underwent ERCP at Chosun university hospital from January 1, 2021 to December 31, 2023. A total of 1775 ERCP procedures were performed during the study period, of which 60 (48 patients) were performed in patients over 90 years of age and were finally enrolled in this study. In all tests, deep sedation was induced by bolus injection of midazolam 1mg and then administration of 10-30mg of propofol. If the procedure time was prolonged, 1mg of midazolam was additionally administered. For each test, blood pressure, heart rate, oxygen saturation and adverse events were recorded before, during, and after the procedure. Adverse events included hypoxia, hypotension, and bradycardia

Results A total of 60 procedures were performed, the mean age of the patients was 92.60±3.38 years, and 75% were female. The American Society of Anesthesiologists physical status (ASA) score was 13.3% for I, 40.0% for II, 43.3% for III, and 3.3% for IV. The average amount of total propofol dose is 60.17±38.64mg, the procedure time is 23.88±11.41 min, and the recovery time is 7.53±4.78 min. 1 patient (1.7%) experienced an adverse event during the procedure. The side effect was hypoxemia, and the patient recovered with O2 supply through nasal cannula. In the analysis of risk factors related to hypoxemia, there were no statistically significant factors [1].

Conclusions Because our study results showed a very low incidence of adverse events, sedation with balanced propofol is considered safe for patients over 90 years of age undergoing ERCP.

 

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Conflicts of Interest

Authors do not have any conflict of interest to disclose.

• References

• 1 Dayna S. Early et al. Gastrointest Endosc 2018 87. 327-337

Publication History

Article published online:
27 March 2025