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The Efficacy of Propofol Alone versus Midazolam Plus Propofol for Colonoscopy
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Cheol Hee Park, Soung Hoon Chang, Jae One Jung, Joon Ho Moon, Woon Geon Shin, Jong Pyo Kim, Kyung Oh Kim, Taeho Hahn, Kyo-Sang Yoo, Sang Hoon Park, Jong Hyeok Kim, Choong Kee Park
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Intest Res 2006;4(2):87-94. Published online December 30, 2006
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- Background/Aims
Recent studies showed that propofol and midazolam act synergistically in combination and therefore it may be superior to sedation with propofol alone in terms of sedating efficacy. We compared the effect of propofol alone and combined use of propofol and midazolam during colonoscopy. Methods: P (propofol alone) group received propofol (2-2.5 ml/kg/hr) plus normal saline (3 ml) and MP (propofol/midazolam) group received propofol (2-2.5 ml/kg/hr) plus midazolam (3 mg). We compared followings in both groups; 1) induction and total propofol dosage 2) induction and procedure time 3) recovery time 4) satisfaction of patients and doctors 5) adverse effects. Results: Induction (9 vs. 12 ml) and total (17 vs. 22 ml) propofol dosage were lower in MP group than P group (p＜0.05). Induction (3.6 vs. 5.5 min) time was shorter in MP group than P group (p＜0.05). In both groups, significant difference was not observed in the change of blood pressure, heart rate, respiration rate, and peripheral blood oxygen saturation rate. Fatal adverse effect was not found in both groups. Conclusions: Combined use of propofol and midazolam is more effective sedative method than the use of propofol alone because of rapid induction and lower propofol dosage without increasing adverse effects. (Intestinal Research 2006;4:87-94)
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Risk Factor of Ischemic Colitis and Usefulness of High-Resolution Ultrasonography
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Woon Geon Shin, Cheol Hee Park, Jae One Jung, Joon Ho Moon, Kyoung Oh Kim, Yong Woo Chung, Gwang Ho Baek, Taeho Hahn, Kyo-Sang Yoo, Sang Hoon Park, Jong Hyeok Kim, Sea Hyub Kae, Kwan Seop Lee, Choong Kee Park
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Intest Res 2006;4(1):32-38. Published online June 30, 2006
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- Background/Aims
Although the majority of ischemic colitis have excellent prognosis by supportive management, there are a lot of controversies in relation to the prognostic factors. Lately, role of sonography has been emphasized in colonic ischemia. The aim of this study is the identification of the prognostic factors and the usefulness of high-resolution ultrasonography in detecting involved site and severity of ischemic colitis. Methods: The clinical databases were reviewed between April 1999 and March 2004. 60 cases were diagnosed as ischemic colitis. Clinical characteristics, coexisting illness, segment of colon involved, and sonographic finding were analyzed. Results: The poor prognosis group was significantly older than the good prognosis group (p=0.017). The difference in involved colonic segment between the two groups was statistically significant (p=0.001). However, in logistic regression, only right colonic involvement was an independent poor prognostic factor (95% confidence interval, 1.7-46.4; p=0.01). Ultrasonography had a sensitivity of 85% and a specificity of 82%. Conclusions: Only right colonic involvement was an independent poor prognostic factor. Noninvasive high-resolution ultrasonography was a valuable technique for the detection and the follow-up of colonic ischemia. Therefore, sigmoidoscopy and sonography are preferable to heavy going colonoscopy in severe colonic ischemia. (Intestinal Research 2006;4:32-38)
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Adult Intussusception: Three-dimensional Reconstruction of Computed Tomography
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Joon Ho Moon, Cheol Hee Park, Kyoung Oh Kim, Taeho Hahn, Kyo-Sang Yoo, Sang Hoon Park, Jong Hyeok Kim, Choong Kee Park
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Intest Res 2006;4(1):69-72. Published online June 30, 2006
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- Intussusceptions in adults are relatively rare. About 70% to 90% of cases have demonstrable etiologies, and 40% of them are caused by malignant neoplasm. Diagnosis may be difficult with conventional diagnostic techniques due to the low incidence and the rare consideration to intussusception in adults. Computed tomography (CT) is now widely used in the evaluation of abdominal mass and nonspecific abdominal pain that may be the first presentation of an intussusception. But, CT is often not successful in determining the specific causes of the intussusception, as the lead point in many cases is small and often hidden within the intussuscepted mass. We report two cases of adult intussusceptions by sigmoid colon cancer with three-dimensional reconstruction of conventional CT. (Intestinal Research 2006;4:69-73)
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The Safety of Colonoscopy Using Sedation with Propofol
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Jong Pyo Kim, Cheol Hee Park, Jae One Jung, Joon Ho Moon, Woon Geon Shin, Kyoung Oh Kim, Tae Ho Han, Kyo Sang Yoo, Sang Hoon Park, Jong Hyeok Kim, Choong Kee Park
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Intest Res 2005;3(1):11-17. Published online June 30, 2005
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The usage of sedative agents like midazolam or propofol and a desire for efficient and safe endoscopy have contributed to changes in the practice of endoscopic sedation. The clinical efficacy and safety of propofol as premedication for outpatient colonoscopy is under evaluation in Korea. We compared propofol to low-dose midazolam for colonoscopy with conscious sedation. Methods: Outpatients undergoing colonoscopy were randomized to receive either propofol or low-dose midazolam (0.05 mg/kg). Total 92 patients were divided into 2 groups (propofol group: 51, low-dose midazolam group: 41). Induction of sedation, procedure and recovery time, patient's and doctor's satisfaction, complications were evaluated. Results: There was no significant difference between two groups in sex ratio and mean age. The changes in blood pressure, pulse rate, respiration rate and oxygen saturation were not significant in both groups. Patients receiving propofol tolerated colonoscopy much more than those with low-dose midazolam. Major complications such as hemodynamic instability or apnea did not occur in both groups. Conclusions: Propofol was safe and effective premedication for conscious sedation in colonoscopy. Propofol has several advantages over low-dose midazolam. (Intest Res 2005;3:11-17)
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Correlation of Abdominal Sonography with Colonoscopy in Inflammatory and Infectious Bowel Disease
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Cheol Hee Park, Jong Hyeok Kim, Jin Cheol Park, Do Kyun Jin, Kil Chan Oh, Chul Sung Park, Kyoung Oh Kim, Kyo-Sang Yoo, Taeho Hahn, Sang Hoon Park, Choong Kee Park, Kwan Seop Lee
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Intest Res 2004;2(2):77-82. Published online December 22, 2004
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Colonoscopy is the most important tool in the evaluation of the bowel diseases. But it needs bowel preparation, causes pain, hemorrhage, and even perforation in acute stage. Since the development of the high resolution ultrasonography, ultrasonography is widely used in the evaluation of the bowel diseases. It does not need bowel preparation and can be used in acute stage. We compared the results obtained by abdominal ultrasonography with the endoscopic findings to evaluate the location and extent of bowel disease. Methods: Ultrasonographic scan and colonoscopy were performed in 70 patients with ulcerative colitis (n=16), Crohn's disease (n=7), tuberculous colitis (n=10), infectious colitis (n=37). Bowel wall thickness was compared with endoscopic findings in a segment-by-segment comparison. A bowel wall thickness of 4 mm or more was considered pathologic. Results: Sensitivity and specificity of ultrasonography were 86%, 97% in ulcerative colitis, 83%, 88% in Crohn's disease, 83%, 97% in tuberculous colitis, 81%, 96% in infectious colitis and 83%, 96% in total patients. Conclusions: Abdominal ultrasonography may be helpful in evaluating the location and extent of bowel disease and especially, follow-up examination in inflammatory bowel disease. (Intestinal Research 2004;2:77-82)
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