Portal de Periódicos da CAPES

NURSE ADMINISTERED PROPOFOL SEDATION

2004; Lippincott Williams & Wilkins; Volume: 99; Linguagem: Inglês

10.14309/00000434-200410001-00912

1572-0241

Douglas K. Rex, Ludwig T. Heuss, John Walker,

Airway Management and Intubation Techniques

Purpose: Nurse administered propofol sedation (NAPS) is currently controversial with regard to safety. Although NAPS has been safe in the available published experience there is concern that dissemination of the approach will be accompanied by serious or fatal events. We sought to examine the safety record of individual nurses and supervising endoscopists to see how often there are outlier performances with regard to safety. Methods: The primary endpoint was cases requiring assisted ventilation. Databases were created prospectively at 3 endoscopy centers employing NAPS. At 2 centers these included all cases from the inception of the program. At 1 center cases were recorded after an initial 6000 cases were performed in which there no events. Results: The total number of cases at the 3 centers was 28,697 and the number of events was 42 (0.14%). Table 1 shows the breakdown by nurses and doctors at the 3 sites. There was no single physician or nurse at any of the sites whose event rate differed from the overall rate for the center. There were no events requiring endotracheal intubation or resulting in death or neurologic sequellae. At 2 centers the event rate was lower for colonoscopy compared to EGD (Center1:0.08% vs 0.24%; Center 3:0.04% vs 0.5%)Table 1Conclusions: NAPS was safe in over 34,000 patients. Among 38 nurses and 35 MDs trained in NAPS there were no outliers with regard to safety, suggesting that large numbers of nurses and MDs could be trained to perform NAPS safely.