Original Article
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Efficacy and Safety of Etomidate in Comparison with Propofol or Midazolam as Sedative for Upper Gastrointestinal Endoscopy
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Jae Hyun Kim, Sanghwan Byun, Youn Jung Choi, Hye Jung Kwon, Kyoungwon Jung, Sung Eun Kim, Moo In Park, Won Moon, Seun Ja Park
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Clin Endosc 2020;53(5):555-561. Published online March 31, 2020
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DOI: https://doi.org/10.5946/ce.2019.210
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Abstract
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- Background
/Aims: In this study, we compared the efficacy and safety of etomidate with those of propofol or midazolam for the maintenance of sedation during endoscopy.
Methods
The study enrolled patients who underwent sedative endoscopy in our hospital and divided them into three groups. Patients in each group were administered midazolam as induction therapy and were subsequently administered either midazolam (M + M group), propofol (M + P group), or etomidate (M + E group) as maintenance medication. The primary outcome was overall cardiovascular and respiratory adverse events.
Results
In total, 105 patients who underwent sedative endoscopic examination were enrolled. The outcomes related to the procedure and sedation were not significantly different among the groups. Overall cardiovascular and respiratory adverse events were observed in 9 patients (25.7%) in the M + M group, 8 patients (23.5%) in the M + P group, and 10 patients (27.8%) in the M + E group. The logistic regression analysis revealed that etomidate use was not an independent risk factor for overall cardiovascular and respiratory adverse events.
Conclusions
The outcomes following the use of etomidate for maintenance after induction with midazolam for sedation in upper gastrointestinal endoscopy were not inferior to those following midazolam or propofol use from the perspectives of safety and efficacy.
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Citations
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- Comparison of ciprofol–alfentanil and propofol–alfentanil sedation during bidirectional endoscopy: A prospective, double-blind, randomised, controlled trial
Jiqiang Zhang, Ruijuan Liu, Ruirui Bi, Xia Li, Mengjun Xu, Lijuan Li, Yuxi su, Wenjun Yan
Digestive and Liver Disease.2024; 56(4): 663. CrossRef - Effects of Earmuffs and Eye Masks on Propofol Sedation during Spinal Anesthesia for Orthopedic Surgery: A Randomized Controlled Trial
Jin-Woo Park, Sung Il Bae, Jungyul Ryu, Seung Hyun Chung, Sang-Hwan Do
Journal of Clinical Medicine.2023; 12(3): 899. CrossRef - Effect of intravenous anesthesia by etomidate in combination with propofol on gastrointestinal endoscopy
Bo CHEN, Ke ZHANG, Mingshuai YU
Minerva Surgery.2023;[Epub] CrossRef - New sedatives and analgesic drugs for gastrointestinal endoscopic procedures
Jae Min Lee, Yehyun Park, Jin Myung Park, Hong Jun Park, Jun Yong Bae, Seung Young Seo, Jee Hyun Lee, Hyung Ku Chon, Jun-Won Chung, Hyun Ho Choi, Jun Kyu Lee, Byung-Wook Kim
Clinical Endoscopy.2022; 55(5): 581. CrossRef - Drugs used for sedation in gastrointestinal endoscopy
Jun Kyu Lee
Journal of the Korean Medical Association.2022; 65(11): 735. CrossRef - Comparative Safety Profiles of Sedatives Commonly Used in Clinical Practice: A 10-Year Nationwide Pharmacovigilance Study in Korea
Yeo-Jin Choi, Seung-Won Yang, Won-Gun Kwack, Jun-Kyu Lee, Tae-Hee Lee, Jae-Yong Jang, Eun-Kyoung Chung
Pharmaceuticals.2021; 14(8): 783. CrossRef - Physical and Chemical Compatibility of Etomidate and Propofol Injectable Emulsions
Chunling Wang, Shengnan Wang, Cuishuan Wu, Li Lei, Dong-Xin Wang, Qiang Zhang
Pharmacology.2021; 106(11-12): 644. CrossRef
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Commentary
Original Article
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Effect of Sending Educational Video Clips via Smartphone Mobile Messenger on Bowel Preparation before Colonoscopy
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Sung Chan Jeon, Jae Hyun Kim, Sun Jung Kim, Hye Jung Kwon, Youn Jung Choi, Kyoungwon Jung, Sung Eun Kim, Won Moon, Moo In Park, Seun Ja Park
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Clin Endosc 2019;52(1):53-58. Published online August 29, 2018
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DOI: https://doi.org/10.5946/ce.2018.072
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Abstract
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- Background
/Aim: We aimed to evaluate the efficacy of sending educational video clips via smartphone mobile messenger (SMM) on enhancing bowel preparation before colonoscopy.
Methods
This was a prospective, endoscopist-blinded, randomized controlled study. Patients in the SMM group received two video clips sent via SMM that explained the diet and regimen for bowel preparation, whereas those in the control group did not receive any video clips. We compared the quality of bowel preparation between the two groups, which was assessed by an endoscopist using the Ottawa scale.
Results
Between August and November 2014, 140 patients in the SMM group and 141 patients in the control group underwent colonoscopic examination. The total Ottawa score of the SMM group was significantly lower than that of the control group (5.47±1.74 vs. 5.97±1.78, p=0.018). These results were particularly prominent in the younger age group; the total Ottawa score of patents in the SMM group aged <40 years was significantly lower than that of patients in the control group aged <40 years (5.10±1.55 vs. 6.22±2.33, p=0.034).
Conclusions
We demonstrated that sending educational video clips via SMM could result in better bowel preparation, especially in the younger age group.
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Citations
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Endoscopy International Open.2024; 12(03): E402. CrossRef - Improving Colonoscopy Preparation Using Information and Communication Technologies (ICT), Randomized Clinical Trial
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Review
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Borrmann Type 4 Advanced Gastric Cancer: Focus on the Development of Scirrhous Gastric Cancer
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Kyoungwon Jung, Moo In Park, Sung Eun Kim, Seun Ja Park
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Clin Endosc 2016;49(4):336-345. Published online July 25, 2016
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DOI: https://doi.org/10.5946/ce.2016.057
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Abstract
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- Early diagnosis of Borrmann type 4 advanced gastric cancer (AGC) is very important for improving the prognosis of AGC patients. Because there is no definite mass in most cases of Borrmann type 4 AGC, its accurate diagnosis via endoscopy requires an understanding of its pathogenesis and developmental process. Moreover, many people confuse linitis plastica (LP) type gastric cancer (GC), scirrhous GC, and Borrmann type 4 AGC. To distinguish each of these cancers, knowledge of their endoscopic and pathological differences is necessary, especially for LP type GCs in the developmental stage. In conclusion, diagnosis of pre-stage or latent LP type GC before progression to typical LP type GC requires the detection of IIc-like lesions in the fundic gland area. It is also crucial to identify any abnormalities such as sclerosis of the gastric wall and hypertrophy of the mucosal folds during endoscopy.
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Original Article
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Observer Variability in Gastric Neoplasm Assessment Using the Vessel Plus Surface Classification for Magnifying Endoscopy with Narrow Band Imaging
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Chan Hui Yoo, Moo In Park, Seun Ja Park, Won Moon, Hyung Hun Kim, Jun Young Song, Do Hyun Kim
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Clin Endosc 2014;47(1):74-78. Published online January 24, 2014
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DOI: https://doi.org/10.5946/ce.2014.47.1.74
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Abstract
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- Background/Aims
Recent studies have demonstrated that magnifying endoscopy with narrow band imaging (ME-NBI) facilitates differentiation of early gastric cancer from gastric adenoma using vessel plus surface (VS) classification. This study estimated the interobserver and intraobserver agreement of endoscopists using the Yao VS classification system for the gastric mucosal surface.
MethodsWe retrospectively reviewed patients who underwent endoscopic submucosal dissection or endoscopic mucosal resection, and selected cases in which preoperative ME-NBI was conducted. Before testing endoscopists, a 20-minute training module was given. Static ME-NBI images (n=47 cases) were presented to seven endoscopists (two experts and five trainees) who were asked to assess the images in 20 seconds using the Yao VS classification system. After 2 weeks, the endoscopists were asked to analyze the images again. The κ statistic was calculated for intraobserver and interobserver variability.
ResultsThe mean κ for intraobserver agreement was 0.69 (experts, 0.74; trainees, 0.64). The mean κ for interobserver agreement was 0.42 (experts, 0.49; trainees, 0.40).
ConclusionsWe obtained reliable results as assessed by observer variability, with only brief training on VS classification. The VS classification appears to provide an objective assessment of ME-NBI for trainees who are not familiar with ME-NBI.
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Anna Nogués-Sabaté, Francesc Xavier Aviles-Jurado, Laura Ruiz-Sevilla, Eduardo Lehrer, Alfonso Santamaría-Gadea, Meritxell Valls-Mateus, Isabel Vilaseca
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Hitoshi Omura, Naohiro Yoshida, Tomoyuki Hayashi, Kazuhiro Miwa, Hajime Takatori, Hirokazu Tsuji, Katsuhisa Inamura, Yukihiro Shirota, Hiroyuki Aoyagi, Takaharu Masunaga, Kazuyoshi Katayanagi, Hiroshi Kurumaya, Shuichi Kaneko, Hisashi Doyama
Gastric Cancer.2017; 20(4): 620. CrossRef - Diagnostic Performance of Narrow Band Imaging for Laryngeal Cancer: A Systematic Review and Meta‐analysis
Changling Sun, Xue Han, Xiaoying Li, Yayun Zhang, Xiaodong Du
Otolaryngology–Head and Neck Surgery.2017; 156(4): 589. CrossRef - Predicting pre‐ and post‐resectional histologic discrepancies in gastric low‐grade dysplasia: A comparison of white‐light and magnifying endoscopy
Jin Won Hwang, Young Seok Bae, Mi Seon Kang, Ji Hyun Kim, Sam Ryong Jee, Sang Heon Lee, Min Sung An, Kwang Hee Kim, Ki Beom Bae, Bomi Kim, Sang Young Seol
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Ying-Ying Hu
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Il Ju Choi
Clinical Endoscopy.2014; 47(1): 1. CrossRef - Assessment of Still and Moving Images in the Diagnosis of Gastric Lesions Using Magnifying Narrow-Band Imaging in a Prospective Multicenter Trial
Tomoyuki Hayashi, Hisashi Doyama, Yukihiro Shirota, Hirokazu Tsuji, Youhei Marukawa, Hajime Ohta, Kazuhiro Miwa, Takaharu Masunaga, Shuichi Terasaki, Yutaka Matano, Kunihiro Tsuji, Yoshibumi Kaneko, Toshihide Okada, Hiroshi Kurumaya, Shuichi Kaneko, John
PLoS ONE.2014; 9(7): e100857. CrossRef
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Case Report
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Successful Endoscopic Mucosal Resection of a Low Esophageal Carcinoid Tumor
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Chang Sup Lim, Seun Ja Park, Moo In Park, Won Moon, Hyung Hun Kim, Jun Sik Lee, Bong Jin Kim, Dong Young Ku
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Clin Endosc 2013;46(5):576-578. Published online September 30, 2013
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DOI: https://doi.org/10.5946/ce.2013.46.5.576
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Abstract
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Esophageal carcinoid tumors remain some of the rarest of all carcinoid tumors, with only several cases previously reported in the literature. The endoscopic mucosal resection of selected carcinoid tumors has been shown to be a valid, safe, and effective method of treatment. Endoscopic ultrasonography is the technique of choice to select patients eligible for endoscopic resection. Here, we report successful endoscopic mucosal resection of a low esophageal carcinoid tumor and review the relevant literature. The present case is the first reported case of esophageal carcinoid tumor in Korea.
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- Role of Advanced Gastrointestinal Endoscopy in the Comprehensive Management of Neuroendocrine Neoplasms
Harishankar Gopakumar, Vinay Jahagirdar, Jagadish Koyi, Dushyant Singh Dahiya, Hemant Goyal, Neil R. Sharma, Abhilash Perisetti
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Lauren M Poston, Shreya Gupta, Christine E Alvarado, Jillian Sinopoli, Leonidas T Vargas, Philip A Linden, Christopher W Towe
Diseases of the Esophagus.2023;[Epub] CrossRef - A rare rarity: Neuroendocrine tumor of the esophagus
Elisa Giannetta, Valentina Guarnotta, Francesca Rota, Federica de Cicco, Federica Grillo, Annamaria Colao, Antongiulio Faggiano
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Sarah K. Findeis, Atin Agarwal
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Konstantinos Triantafyllou, Paraskevas Gkolfakis, Nikos Viazis, Panagiotis Tsibouris, Athanasios Tsigaridas, Periklis Apostolopoulos, John Anastasiou, Eleni Hounda, Ioannis Skianis, Konstantina Katopodi, Xhoela Ndini, George Alexandrakis, Demetrios G. Kar
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Special Issue Article of IDEN 2013
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Endoscopic Treatment for Early Foregut Neuroendocrine Tumors
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Moo In Park
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Clin Endosc 2013;46(5):450-455. Published online September 30, 2013
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DOI: https://doi.org/10.5946/ce.2013.46.5.450
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Abstract
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Foregut neuroendocrine tumors (NETs) include those arising in the esophagus, stomach, pancreas, and duodenum and seem to have a broad range of clinical behavior from benign to metastatic. Several factors including the advent of screening endoscopy may be related to increased incidence of gastrointestinal NETs; thus, many foregut NETs are diagnosed at an early stage. Early foregut NETs, such as those of the stomach and duodenum, can be managed with endoscopic treatment because of a low frequency of lymph node and distant metastases. However, controversy continues concerning the optimal management of early foregut NETs due to a lack of controlled prospective studies. Several issues such as indications, technical issues, and outcomes of endoscopic treatment for early foregut NETs are reviewed based on some published studies.
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- Factors associated with gastric and duodenal neuroendocrine tumors: A multicenter case-control study
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Suk Ki Park, Moon Won Lee, In Sub Han, Young Joo Park, Sung Yong Han, Joon Woo Park, Bong Eun Lee, Gwang Ha Kim, Sang Soo Kim
The Korean Journal of Helicobacter and Upper Gastrointestinal Research.2019; 19(1): 65. CrossRef - Prognostic role of neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio in patients with midgut neuroendocrine tumors undergoing resective surgery
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Waku Hatta, Tomoyuki Koike, Katsunori Iijima, Kiyotaka Asanuma, Naoki Asano, Hiroaki Musha, Yoshifumi Inomata, Toshikazu Sano, Hiroyuki Endo, Atsushi Ikehata, Toru Horii, Motoki Ohyauchi, Satoshi Yokosawa, Atsuko Kasajima, Fumiyoshi Fujishima, Hironobu Sa
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J Barnes, SJ Johnson, JJ French
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V. Fendrich, D. K. Bartsch
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Yu‐Ling Huang, Shah‐Hwa Chou, Chee‐Yin Chai, Jui‐Sheng Hsu
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Original Article
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Effectiveness of Premedication with Pronase for Visualization of the Mucosa during Endoscopy: A Randomized, Controlled Trial
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Gyu Jin Lee, Seun Ja Park, Sun Jung Kim, Hyung Hun Kim, Moo In Park, Won Moon
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Clin Endosc 2012;45(2):161-164. Published online June 30, 2012
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DOI: https://doi.org/10.5946/ce.2012.45.2.161
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Abstract
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- Background/Aims
Gastric mucus should be removed before endoscopic examination to increase visibility. In this study, the effectiveness of premedication with pronase for improving visibility during endoscopy was investigated.
MethodsFrom April 2010 to February 2011, 400 outpatients were randomly assigned to receive endoscopy with one of four premedications as follows: dimethylpolysiloxane (DMPS), pronase and sodium bicarbonate with 10 minutes premedication time (group A, n=100), DMPS and sodium bicarbonate with 10 minutes premedication time (group B, n=100), DMPS, pronase and sodium bicarbonate with 20 minutes premedication time (group C, n=100), and DMPS and sodium bicarbonate with 20 minute premedication time (group D, n=100). One endoscopist, who was unaware of the premedication types, calculated the visibility scores (range, 1 to 3) of the antrum, lower gastric body, upper gastric body and fundus. The sum of the scores from the four locations was defined as the total visibility score.
ResultsGroup C showed significantly lower scores than other groups (p=0.002). Group C also had the lowest frequency of flushing, which was significantly lower than that of group D. Groups C and D had significantly shorter durations of examination than groups A and B.
ConclusionsUsing pronase 20 minutes before endoscopy significantly improved endoscopic visualization and decreased the frequency of water flushing.
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