• Hala Fatima, John DeWitt, Julia LeBlanc, Stuart Sherman, Kathleen McGreevy, and Thomas F Imperiale.
• Division of Gastroenterology, Department of Medicine, Indiana University Medical Center, Indianapolis, Indiana 46202-5121, USA.
• Am. J. Gastroenterol. 2008 Jul 1;103(7):1649-56.

BackgroundLimited data exist regarding the safety of nurse-administered propofol sedation (NAPS) for advanced endoscopy.AimsTo evaluate the frequency of and the risk factors for complications associated with NAPS for upper endoscopic ultrasound (EUS).MethodsConsecutive upper EUS examinations using NAPS were retrospectively identified. Clinical data and adverse events were recorded. Univariate and multivariable repeated measures logistic regression models were used to identify independent risk factors for complications.ResultsAmong 806 EUS procedures, the mean procedure duration, time for sedation induction, and postprocedure recovery time were: 34 +/- 20 min, 3.6 +/- 1.4 min, and 27 +/- 23 min, respectively. A decline in systolic blood pressure (SBP) to <90 mm Hg occurred in 104 patients (13%). Six patients (0.7%) had a decline in oxygen saturation (SpO(2)) to <90%. Four patients (0.5%; 95% confidence interval [CI] 0.14-1.27) required assisted positive pressure ventilation. There were no major complications. The minor complication rate from sedation was 21% (95% CI 17.2-25.3). All of the complications were clinically insignificant. Overall complication risk was not related to age, dose, or procedure time. Sedation-related complication rates for advanced experience-level (> or =100 NAPS procedures) nurses were lower compared to the least-experienced (< or =30 NAPS procedures) nurses (17.2%vs 25.4%, odds ratio [OR] 0.61, 95% CI 0.41-0.92).ConclusionsNAPS for upper EUS is safe and may be performed without major complications. Four patients (0.5%) required assisted ventilation. Minor complications occurred in 21% of patients, but were not associated with patient age, propofol dose, or procedure time.

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