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Shin S, Oh TG, Chung MJ, Park JY, Park SW, Chung JB, Song SY, Cho J, Park SH, Yoo YC, Bang S. Conventional versus Analgesia-Oriented Combination Sedation on Recovery Profiles and Satisfaction after ERCP: A Randomized Trial. PLoS One 2015; 10:e0138422. [PMID: 26402319 PMCID: PMC4581832 DOI: 10.1371/journal.pone.0138422] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2015] [Accepted: 08/27/2015] [Indexed: 12/28/2022] Open
Abstract
Background The importance of providing effective analgesia during sedation for complex endoscopic procedures has been widely recognized. However, repeated administration of opioids in order to achieve sufficient analgesia may carry the risk of delayed recovery after propofol based sedation. This study was done to compare recovery profiles and the satisfaction of the endoscopists and patients between conventional balanced propofol sedation and analgesia-oriented combination sedation for patients undergoing endoscopic retrograde cholangiopancreatography (ERCP). Methods Two hundred and two adult patients scheduled for ERCP were sedated by either the Conventional (initial bolus of meperidine with propofol infusion) or Combination (repeated bolus doses of fentanyl with propofol infusion) method. Recovery profiles, satisfaction levels of the endoscopists and patients, drug requirements and complications were compared between groups. Results Patients of the Combination Group required significantly less propofol compared to the Conventional Group (135.0 ± 68.8 mg vs. 165.3 ± 81.7 mg, P = 0.005). Modified Aldrete scores were not different between groups throughout the recovery period, and recovery times were also comparable between groups. Satisfaction scores were not different between the two groups in both the endoscopists and patients (P = 0.868 and 0.890, respectively). Conclusions Considering the significant reduction in propofol dose, the non-inferiority of recovery profiles and satisfaction scores of the endoscopists and patients, analgesia oriented combination sedation may be a more safe yet effective sedative method compared to conventional balanced propofol sedation during ERCP.
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Affiliation(s)
- Seokyung Shin
- Department of Anesthesiology and Pain Medicine, Severance Hospital, Anesthesia and Pain Research Institute, Yonsei University College of Medicine, 50–1 Yonsei-ro, Seodaemun-gu, 03722, Seoul, Korea
| | - Tak Geun Oh
- Division of Gastroenterology, Department of Internal Medicine, Severance Hospital, Institute of Gastroenterology, Yonsei University College of Medicine, 50–1 Yonsei-ro, Seodaemun-gu, 03722, Seoul, Korea
| | - Moon Jae Chung
- Division of Gastroenterology, Department of Internal Medicine, Severance Hospital, Institute of Gastroenterology, Yonsei University College of Medicine, 50–1 Yonsei-ro, Seodaemun-gu, 03722, Seoul, Korea
| | - Jeong Youp Park
- Division of Gastroenterology, Department of Internal Medicine, Severance Hospital, Institute of Gastroenterology, Yonsei University College of Medicine, 50–1 Yonsei-ro, Seodaemun-gu, 03722, Seoul, Korea
| | - Seung Woo Park
- Division of Gastroenterology, Department of Internal Medicine, Severance Hospital, Institute of Gastroenterology, Yonsei University College of Medicine, 50–1 Yonsei-ro, Seodaemun-gu, 03722, Seoul, Korea
| | - Jae Bok Chung
- Division of Gastroenterology, Department of Internal Medicine, Severance Hospital, Institute of Gastroenterology, Yonsei University College of Medicine, 50–1 Yonsei-ro, Seodaemun-gu, 03722, Seoul, Korea
| | - Si Young Song
- Division of Gastroenterology, Department of Internal Medicine, Severance Hospital, Institute of Gastroenterology, Yonsei University College of Medicine, 50–1 Yonsei-ro, Seodaemun-gu, 03722, Seoul, Korea
| | - Jooyoun Cho
- Department of Anesthesiology and Pain Medicine, Severance Hospital, Anesthesia and Pain Research Institute, Yonsei University College of Medicine, 50–1 Yonsei-ro, Seodaemun-gu, 03722, Seoul, Korea
| | - Sang-Hun Park
- Department of Anesthesiology and Pain Medicine, Severance Hospital, Anesthesia and Pain Research Institute, Yonsei University College of Medicine, 50–1 Yonsei-ro, Seodaemun-gu, 03722, Seoul, Korea
| | - Young Chul Yoo
- Department of Anesthesiology and Pain Medicine, Severance Hospital, Anesthesia and Pain Research Institute, Yonsei University College of Medicine, 50–1 Yonsei-ro, Seodaemun-gu, 03722, Seoul, Korea
- * E-mail: (SB); (YCY)
| | - Seungmin Bang
- Division of Gastroenterology, Department of Internal Medicine, Severance Hospital, Institute of Gastroenterology, Yonsei University College of Medicine, 50–1 Yonsei-ro, Seodaemun-gu, 03722, Seoul, Korea
- * E-mail: (SB); (YCY)
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Lu CH, Huang CY, Park JH, Lin HR, Lee YL, Cheng SF. Main Caregivers’ Experiences of Managing Pain for Children With Neuroblastoma in Taiwan. J Pediatr Oncol Nurs 2011; 28:326-35. [DOI: 10.1177/1043454211408104] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Neuroblastoma is a common malignant tumor among children. Seventy percent of children with neuroblastoma have metastatic disease when the diagnosis is established. The aim of this study was to understand the main caregivers’ lived experiences in managing pain for children with neuroblastoma. A descriptive qualitative design was used. Twelve main caregivers of children with neuroblastoma were interviewed. Two themes evolved: experiences of pain and coping with pain. Three subthemes were found under the theme “experience of pain”: pain assessment based on language expressions and behavioral observations, tendency of misdiagnosing tumor metastasis–related pain, and unique manifestations of pain at various phases. Four subthemes evolved under the theme “coping with pain”: utilization of pharmacological and nonpharmacological modalities for pain management, learning to confront pain, seeking mental and emotional support, and adjustment of family lifestyle. The results provide a description regarding the expression of pain in children with neuroblastoma and the pain management modalities used by the main caregivers. The findings serve as a reference for health care providers in Taiwan as they manage pain for children with neuroblastoma and seek to understand the needs of the main caregivers.
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Affiliation(s)
| | | | | | - Hung-Ru Lin
- National Taipei University of Nursing and Health Sciences, Taipei, Taiwan, ROC
| | - Ya-Ling Lee
- National Taiwan University, Taipei, Taiwan, ROC
| | - Su-Fen Cheng
- National Taipei University of Nursing and Health Sciences, Taipei, Taiwan, ROC
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