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Record W4255718899 · doi:10.1093/jcag/gwy009.212

A212 ENDOSCOPIST-DIRECTED PROPOFOL AS AN ADJUNCT TO STANDARD SEDATION: A CANADIAN EXPERIENCE

2018· article· en· W4255718899 on OpenAlexaffabout
Valérie Heron, Charlotte Golden, Robert Battat, Polymnia Galiatsatos, Barry Stein, Jonathan Wyse, Alexandra Cohen

Bibliographic record

VenueJournal of the Canadian Association of Gastroenterology · 2018
Typearticle
Languageen
FieldMedicine
TopicEnhanced Recovery After Surgery
Canadian institutionsMcGill University Health CentreJewish General HospitalMcGill University
Fundersnot available
KeywordsPropofolMedicineSedationFentanylMidazolamAnesthesiaAdverse effectIntubationEndoscopyColonoscopySurgeryColorectal cancerCancerInternal medicine

Abstract

fetched live from OpenAlex

Sedation practices vary widely by region. In Canada, endoscopist-directed administration of a combination of fentanyl and midazolam is standard practice, with only a minority of cases performed with propofol. To demonstrate the safety of non-anesthetist administered propofol for endoscopic sedation. This was a single-centre retrospective cohort study of patients having undergone endoscopic procedures with propofol sedation between 2004 and 2012 in an academic hospital in Montreal. Procedures were performed by gastroenterologists trained in Advanced Cardiovascular Life Support. Sedation was administered by IV bolus by a registered nurse, under the direction of the endoscopist. Outcomes of procedures were collected using the hospital’s endoscopy database. 4955 patients were included. Cecal intubation rate for colonoscopies (n=2920) was 90.0%. Gastroscopies (n=1625), flexible sigmoidoscopies (n=28), ERCP (n=341) and PEG insertion (n=41) had success rates of 98.4%, 96.4%, 94.4% and 92.7% respectively. The average dose of propofol used for each procedure was 34.6 mg. Fentanyl was used in 68% of procedures at an average dose of 94.4 mcg. Versed was used in 92.9% of cases at an average dose of 3.0 mg. Reversal agents (naloxone or flumazenil) were used in 0.4% of cases (n=21). Patients having received reversal agents were discharged uneventfully within the usual post-procedure recovery time. One patient required transfer to the ER. Most patients having received propofol in addition to standard sedation agents experienced no adverse events (99.6%). There were no deaths. The use of propofol administered by a registered nurse under the direction of the endoscopist as an adjunct to fentanyl and versed is safe and effective. None

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

How this classification was reachedexpand

Full frame distilled prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.

metaresearch head score (Codex)0.001
metaresearch head score (Gemma)0.001
Version: codex-gemma-dda1882f352aValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Observational · Consensus signal: Observational
GenreCandidate signal: Empirical · Consensus signal: Empirical
Teacher disagreement score0.853
Threshold uncertainty score0.915

Codex and Gemma teacher scores by category

CategoryCodexGemma
Metaresearch0.0010.001
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0000.000
Bibliometrics0.0010.000
Science and technology studies0.0000.000
Scholarly communication0.0000.000
Open science0.0000.000
Research integrity0.0000.000
Insufficient payload (model declined to judge)0.0000.000

Machine scores (provisional)

The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.

Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.

Opus teacher head0.009
GPT teacher head0.261
Teacher spread0.252 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one teacher head, not a consensus.

The models applied no category: nothing in the taxonomy fit this work.
Study designObservational
Domainnot available
GenreEmpirical

How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".

Quick stats

Citations0
Published2018
Admission routes2
Has abstractyes

Explore more

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