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Intragastric balloon positioning and removal: sedation or general anesthesia?
- Source :
- Surgical endoscopy. 25(12)
- Publication Year :
- 2010
-
Abstract
- Different anesthesiological techniques are currently used for intragastric balloon positioning and removal. The aim of this study is to compare different anesthesiological approaches for balloon positioning and removal in a large multicentric patient population.Retrospective multicenter study was conducted. From May 2000 to April 2008, 3,824 patients underwent BIB(®) placement [1,022 male/2,802 female; mean age 39.5 ± 14.7 years, range 12-71 years; mean body mass index (BMI) 44.8 ± 9.7 kg/m(2), range 28.0-79.1 kg/m(2); excess weight (EW) 59.1 ± 29.8 kg, range 16-210 kg; %EW 89.3 ± 31.7, range 21.4-262]. Patients were allocated to three groups according to anesthesiological technique used: conscious sedation (group A), deep sedation (group B), and general anesthesia (group C). Intragastric balloon was placed after diagnostic endoscopy and removed after 6 months. Both positioning and removal were done under different protocols. Conscious sedation was obtained with topical lidocaine spray, adding diazepam (0.05-0.1 mg/kg iv) or midazolam (0.03-0.05 mg/kg iv). Deep sedation was obtained with propofol alone or adding other drugs such as midazolam, meperidine/fentanyl or meperidine/fentanyl + midazolam. General anesthesia was obtained with midazolam premedication (0.01-0.02 mg/kg iv) followed by induction with propofol (1-1.5 mg/kg iv) + Norcuron (80 mcg/kg iv) + fentanyl (0.5-1 mcg/kg iv), and maintenance with propofol (50-150 μg/kg/min) or sevorane. Oxygen saturation, hemodynamic stability, major anesthesiological complications and related mortality, patient satisfaction, time to return to autonomous walking, duration of procedure, and hospital stay were considered.Sedation-related mortality was absent. A significant number of patients with bronchoinhalation during balloon removal was observed with general anesthesia (P0.001).BIB positioning and removal should be performed under conscious sedation for patient safety and comfort, and technical success.
- Subjects :
- Adult
Male
medicine.medical_specialty
Adolescent
Sedation
Anesthetics, General
Conscious Sedation
Bariatric Surgery
Anesthesia, General
Balloon
bib
conscious sedation
deep sedation
general anesthesia
intragastric balloon
morbid obese
Young Adult
mental disorders
medicine
Humans
Hypnotics and Sedatives
Gastric balloon
Child
Device Removal
Aged
Gastric Balloon
Retrospective Studies
business.industry
Middle Aged
Surgery
Patient population
Multicenter study
Patient Satisfaction
Anesthesia
medicine.symptom
business
psychological phenomena and processes
Subjects
Details
- ISSN :
- 14322218
- Volume :
- 25
- Issue :
- 12
- Database :
- OpenAIRE
- Journal :
- Surgical endoscopy
- Accession number :
- edsair.doi.dedup.....2bde0707decbd10ce2e53f6b62f82793