Evidence map›Paper›PMID 34916051›Full record

SynthesisBritish journal of anaesthesia2022

Hypotension during propofol sedation for colonoscopy: a retrospective exploratory analysis and meta-analysis.

J Robert Sneyd, Anthony R Absalom, Clemens R M Barends, Jordan B Jones

2 registry-linked trialsOpen access · hybridAbstract readMeta-AnalysisReview
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in British journal of anaesthesia, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 123 papers, 11 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
123citing papers in PubMed, 11 pooled it
26.6field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT06009991 naunknown statusnot on this mapstarted 2023, after this paper: background citation

The Investigation of the Dose Range of Remimazolam Besylate in Different Age Groups of Adults and Its Effects on Hemodynamics

TypeinterventionalSponsorTongji HospitalRan2023 to 2025Enrolled1,876ConditionsRemimazolam, AnesthesiaArmsRemimazolam besylate, Propofol
NCT06095570 phase4unknown statusnot on this map

The Study of Ciprofol for the Suppression of Cardiovascular Responses to Tracheal

TypeinterventionalSponsorThe Second Affiliated Hospital of Hainan Medical UniversityRan2022 to 2023Enrolled150ConditionsIntubation, Intratracheal, Adverse EffectsArmsCiprofol, Remimazolam
3 · Its place in the literature

Who cites it

123 citing papers in PubMed, 11 syntheses or guidelines pooled it, 168 citations in OpenAlex.

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  9. The use of remimazolamFrontiers in pharmacology · 2023
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63 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

4 authors at 3 institutions in 3 countries.

J Robert SneydFaculty of Medicine and Dentistry, University of Plymouth, Plymouth, UK. Electronic address: robert.sneyd@pms.ac.uk.
Anthony R AbsalomDepartment of Anesthesiology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.
Clemens R M BarendsDepartment of Anesthesiology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.
Jordan B JonesCollege of Osteopathic Medicine, Rocky Vista University, Ivins, UT, USA.
University of Groningen · NLRocky Vista University · USUniversity of Plymouth · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIntraoperative and postoperative hypotension occur commonly and are associated with organ injury and poor outcomes. Changes in arterial blood pressure (BP) during procedural sedation are not well described.

methodsIndividual patient data from five trials of propofol sedation for colonoscopy and a clinical database were pooled and explored with logistic and linear regression. A literature search and focused meta-analysis compared the incidence of hypotension with propofol and alternative forms of procedural sedation. Hypotensive episodes were characterised by the original authors' definitions (typically systolic BP <90 mm Hg).

resultsIn pooled individual patient data (n=939), 36% of procedures were associated with episodes of hypotension. Longer periods of propofol sedation and larger propofol doses were associated with longer-lasting and more-profound hypotension. Amongst 380 patients for whom individual BP measurements were available, 107 (28%) experienced systolic BP <90 mm Hg for >5 min, and in 89 (23%) the episodes exceeded 10 min. Meta-analysis of 18 RCTs identified an increased risk ratio for the development of hypotension in procedures where propofol was used compared with the use of etomidate (two studies; n=260; risk ratio [RR] 2.0 [95% confidence interval: 1.37-2.92]; P=0.0003), remimazolam (one study; n=384; RR 2.15 [1.61-2.87]; P=0.0001), midazolam (14 studies; n=2218; RR 1.46 [1.18-1.79]; P=0.0004), or all benzodiazepines (15 studies; n=2602; 1.67 [1.41-1.98]; P<0.00001). Hypotension was less likely with propofol than with dexmedetomidine (one study; n=60; RR 0.24 [0.09-0.62]; P=0.003).

conclusionsHypotension is common during propofol sedation for colonoscopy and of a magnitude and duration associated with harm in surgical patients.

Indexed as

HypotensionPropofolColonoscopyHumansHypnotics and SedativesMidazolamRetrospective StudiesHypnotics and SedativesMidazolamPropofolcolonoscopyendoscopyhypotensionmidazolampropofolsedation

Identifiers

PMID34916051
PMCPMC9008870
OpenAlexW4200616521

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.