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AuthorHann, Alexanderdc.contributor.author
AuthorGruss, Saschadc.contributor.author
AuthorGoetze, Sebastiandc.contributor.author
AuthorMehlhase, Niklasdc.contributor.author
AuthorFrisch, Stephandc.contributor.author
AuthorWalter, Benjamindc.contributor.author
AuthorWalter, Steffendc.contributor.author
Date of accession2021-06-25T12:05:40Zdc.date.accessioned
Available in OPARU since2021-06-25T12:05:40Zdc.date.available
Date of first publication2021-06-16dc.date.issued
AbstractBackground: Nurse assisted propofol sedation (NAPS) is a common method used for colonoscopies. It is safe and widely accepted by patients. Little is known, however, about the satisfaction of clinicians performing colonoscopies with NAPS and the factors that negatively influence this perception such as observer-reported pain events. In this study, we aimed to correlate observer-reported pain events with the clinicians' satisfaction with the procedure. Additionally, we aimed to identify patient biosignals from the autonomic nervous system (B-ANS) during an endoscopy that correlate with those pain events. Methods: Consecutive patients scheduled for a colonoscopy with NAPS were prospectively recruited. During the procedure, observer-reported pain events, which included movements and paralinguistic sounds, were simultaneously recorded with different B-ANS (facial electromyogram (EMG), skin conductance level, body temperature and electrocardiogram). After the procedure, the examiners filled out the Clinician Satisfaction with Sedation Instrument (CSSI). The primary endpoint was the correlation between CSSI and observer-reported pain events. The second primary endpoint was the identification of B-ANS that make it possible to predict those events. Secondary endpoints included the correlation between CSSI and sedation depth, the frequency and dose of sedative use, polyps resected, resection time, the duration of the procedure, the time it took to reach the coecum and the experience of the nurse performing the NAPS. ClinicalTrials.gov: NCT03860779. Results: 112 patients with 98 (88.5%) available B-ANS recordings were prospectively recruited. There was a significant correlation between an increased number of observer-reported pain events during an endoscopy with NAPS and a lower CSSI (r = −0.318, p = 0.001). Additionally, the EMG-signal from facial muscles correlated best with the event time points, and the signal significantly exceeded the baseline 30 s prior to the occurrence of paralinguistic sounds. The secondary endpoints showed that the propofol dose relative to the procedure time, the cecal intubation time, the time spent on polyp removal and the individual nurse performing the NAPS significantly correlated with CSSI. Conclusion: This study shows that movements and paralinguistic sounds during an endoscopy negatively correlate with the satisfaction of the examiner measured with the CSSI. Additionally, an EMG of the facial muscles makes it possible to identify such events and potentially predict their occurrence.dc.description.abstract
Languageendc.language.iso
PublisherUniversität Ulmdc.publisher
LicenseCC BY 4.0 Internationaldc.rights
Link to license texthttps://creativecommons.org/licenses/by/4.0/dc.rights.uri
Dewey Decimal GroupDDC 610 / Medicine & healthdc.subject.ddc
MeSHColonoscopydc.subject.mesh
MeSHDeep sedationdc.subject.mesh
MeSHConscious sedationdc.subject.mesh
MeSHAutonomic nervous systemdc.subject.mesh
MeSHPropofoldc.subject.mesh
TitleAutonomous nervous response during sedation in colonoscopy and the relationship with clinician satisfactiondc.title
Resource typeWissenschaftlicher Artikeldc.type
VersionpublishedVersiondc.description.version
DOIhttp://dx.doi.org/10.18725/OPARU-38064dc.identifier.doi
URNhttp://nbn-resolving.de/urn:nbn:de:bsz:289-oparu-38126-0dc.identifier.urn
GNDColoskopiedc.subject.gnd
GNDSedierungdc.subject.gnd
GNDVegetatives Nervensystemdc.subject.gnd
GNDBiosignaldc.subject.gnd
InstitutionUKU. Klinik für Innere Medizin Iuulm.affiliationSpecific
InstitutionUKU. Klinik für Psychosomatische Medizin und Psychotherapieuulm.affiliationSpecific
Peer reviewjauulm.peerReview
DCMI TypeTextuulm.typeDCMI
CategoryPublikationenuulm.category
In cooperation withUniversität Würzburguulm.cooperation
DOI of original publication10.3389/fmed.2021.643158dc.relation1.doi
Source - Title of sourceFrontiers in Medicinesource.title
Source - Place of publicationFrontiers Mediasource.publisher
Source - Volume8source.volume
Source - Year2021source.year
Source - Article number643158source.articleNumber
Source - eISSN2296-858Xsource.identifier.eissn
Open AccessDOAJ Gold, Green Publisheduulm.OA
WoS000668113800001uulm.identifier.wos
Bibliographyuulmuulm.bibliographie
Is Supplemented Byhttps://www.frontiersin.org/articles/10.3389/fmed.2021.643158/full#supplementary-materialdc.relation.isSupplementedBy
xmlui.metadata.uulm.OAfundingOpen-Access-Förderung durch die Medizinische Fakultät der Universität Ulmuulm.OAfunding


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