Recovery Time and Complications of Propofol-Based Deep Sedation for Endoscopic Ultrasonography: A Comparison between With and Without Topical Pharyngeal Anesthesia

Objective: The study is aimed to compare the recovery time and sedation-related complication in propofol-based deep sedation (PBDS) with and without topical pharyngeal anesthesia for EUS procedures in adult Thai population. Material and Method: Thirty-two adult patients undergoing EUS procedures were equally randomly assigned to receive pharyngeal topicalized either with lidocaine spray (Group L) or normal saline (Group N). All patients were premedicated with 1 mcg/kg of fentanyl and 0.02 mg/kg of midazolam. PBDS was maintained with continuous propofol infusion. Recovery time using postanesthetic recovery score and discharge score as well as sedation-related complications were evaluated. Total doses of propofol, fentanyl and midazolam as well as arterial blood pressure values were also recorded. Results: All EUS procedures were completely successful. There were no significant differences in gender, age, body mass index, ASA physical status, duration of procedure and indications of procedure between the two groups. The recovery time, respiratory-related complications, and total doses of propofol, fentanyl and midazolam in both groups were not significantly different. Hypotension in group L was significantly greater than in group N. In addition, hypertension in group L was significantly lower than in group N. However, these complications were transient and easily treated. Conclusion: Addition of topical pharyngeal anesthesia in PBDS technique did not promote the recovery time and not increase the complication rate during and after EUS procedure. PBDS in both regimens provided effective and safe for EUS. No serious complications were noted.