1018 Prospective Randomized Trial of the 22G EchoTip Procore™ Needle Versus the 22G Cook EchoTip Ultra 3® Needle in Patients With Solid Mass Lesions Undergoing EUS-Guided Fine Needle Aspiration (FNA)

Endoscopists Directed Propofol Administration (EDPA) in All BMI Groups: Safe and Effective Iyad M. Subei*, Abdulrahman AL Mahdi, Omar AL-Subee Medicine, Jeddah Center for Liver & Digestive Diseases; Erfan Hospital, Jeddah, Saudi Arabia Background And Aim: Propofol is highly effective short acting substance that is generally used by anesthesiologists to induce general anesthesia. However, several studies done worldwide have proved that propofol is very safe and effective sedative if properly used in endoscopic GI procedures. On the other hand, there has been a concern regarding using it in obese patients, because they might require higher doses of Propofol & they are more predisposed to respiratory complications. In this study, we looked at the efficacy and safety of EDPA in relation to BMI . Methods: We retrospectively analyzed the outcome of 1660 pts (916M /744 F) age 1570; all were ASA* I & II who underwent all diagnostic and therapeutic endoscopic GI procedures and sedated with EDPA between 12/25/2011 & 10/31/2012. All pt’s.were continuously monitored with pulse oximetry and BP measuring during the procedures & recovery until they left the unit well alerts & oriented.According to their BMI, Pt’s. were classified into: Group I: BMI 25 (472 pts/ 28.4%); II:BMI 25-29.9 (497 pts/ 29.9%); III: BMI 30-35 (416pts/ 25%); IV BMI: 35 (275 pts/ 15.6%). Results: All patients tolerated their procedures very well; there was no single mortality nor morbidity; in three (3)pt’s., O2 dropped 85% requiring aborting the procedures and applying O2 via mask ventilation; all regained their O2 saturation in few minutes without the need for endo-tracheal intubation. Two(2) of them belonged to group (I) & one(1) pt. belonged to group (II), but non in group III or IV. Propofol dose /pt. among all the four groups was almost comparable ( Group I: 82.5 mg/SD 57.8; group II:80.6 mg/ SD 57.8; group III: 87.9 mg/ SD 50.9; group IV: 85.7mg/ SD 45). Conclusion: From the above data, it seems that EDPA based sedation is very safe and effective among different BMI groups. In our study we found that the procedures could be successfully accomplished with almost the same dose of Propofol/pt. in all BMI groups. EDPA could be proven not only effective, but also cost saving in the trained hand even in obese patients. However, other studies are needed to confirm this observation.(*) ASA: clinical patient’s classification according to American Society of Anesthesiologists.