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Value of Capnography During Nurse Administered Propofol Sedation (NAPS)

This study has been completed.
Sponsor:
ClinicalTrials.gov Identifier:
NCT01507623
First Posted: January 11, 2012
Last Update Posted: January 11, 2012
The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details.
Collaborator:
The Ministry of Science, Technology and Innovation, Denmark
Information provided by (Responsible Party):
Charlotte Slagelse, University Hospital, Gentofte, Copenhagen
November 24, 2011
January 11, 2012
January 11, 2012
September 2010
February 2011   (Final data collection date for primary outcome measure)
The number of hypoxic events [ Time Frame: The sum of events registered during procedures (procedure duration is, depending on the type, 3 to 90 minutes) ]
If the addition of capnography to standard monitoring can reduce the number of hypoxic events in patients undergoing endscopy with NAPS. A hypoxic event is defined as an observed oxygen saturation of less than 92% . Data is collected by a computer with intervals of 12 sec as the smallest possible.
Same as current
No Changes Posted
  • Actions taken against respiratory insufficiency [ Time Frame: Registered during procedure(procedure duration is, depending on the type, 3 to 90 minutes) ]
    Whether more or less actions are taken against respiratory insufficiency with or without capnography in patients undergoing endoscopy with NAPS.
  • The duration of hypoxia [ Time Frame: The sum of time with hypoxia registered during procedures (procedure duration is, depending on the type, 3 to 90 minutes) ]
    The duration of hypoxia is measured as the sum of registrations(each registration represents 12 seconds) with an oxygen saturation of less than 92 percent. Data is collected by a computer with intervals of 12 sec as the smallest possible.
  • The level of hypoxia [ Time Frame: The sum of events registered at each level during procedures (procedure duration is, depending on the type, 3 to 90 minutes) ]

    Saturation is registered every 12 seconds into a computer. Hypoxia (saturation <92%) was divided into three levels of hypoxia: 1. <92% - 90%,2. <90% - 88%, 3. <88%.

    And the number of events in each group was summed up.

Same as current
Not Provided
Not Provided
 
Value of Capnography During Nurse Administered Propofol Sedation (NAPS)
The Role of Capnography in Endoscopy Patients Undergoing Nurse Administered Propofol Sedation (NAPS): A Randomized Study
Propofol is widely used by anaesthesiologists for deep sedation and general anaesthesia. During recent years nurses trained in the use of low dose Propofol sedation (NAPS) during endoscopy have been introduced. The method has been implemented at the endoscopic unit at Gentofte hospital since 2008(1). Propofol has a respiratory depressive effect which may result in depressed oxygen saturation in the blood (hypoxia). Due to a short acting half life this is prevented in the majority of cases. However, in spite of this, hypoxia is experienced in 4,4% of patients receiving propofol during endoscopy at Gentofte Hospital (unpublished data). It is well known that hypoxia constitutes a late expression of reduced oxygen tension in peripheral tissues. Whether the addition of capnography to standard monitoring during NAPS may be of benefit is widely unknown. The aim of this study is to examine whether the additional use of capnography to standard monitoring during endoscopy may improve patient safety in patients undergoing low dose Propofol sedation by reducing the number, duration and level of hypoxic events. The trial is a randomized clinical prospective case-control study.
Not Provided
Interventional
Not Provided
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)
Primary Purpose: Prevention
Hypoxia
Device: Capnography (Phillips MP20 monitor)

In the intervention group the NAPS nurse observed possible hypoxia and changes in capnography curves/values during the procedure and was instructed to decrease propofol and take actions against insufficient ventilation* if etCO2 ≥ 7kPa or ≤ 2 kPa for ≥ 1 minute, if respiratory frequency ≤ 8 or a loss of curve shape was registered.

*Suction, increase oxygen supply, tongue holder or nasal airway, bag-mask ventilation,paged anaesthesia Discontinued procedures

Other Names:
  • Capnography: Phillips MP20 monitor
  • Nasal cannulae: Smart CapnoLine GuardianTM
  • Experimental: With Capnograpy
    Intervention group with the addition of capnography to standard monitoring (non-invasive blood pressure, pulse, pulse oximetry, clinical observation of respiration, electrocardiography (ECG) and respiratory frequency measured by the ECG)
    Intervention: Device: Capnography (Phillips MP20 monitor)
  • No Intervention: No Capnography
    Control group without the addition of capnography to standard monitoring (non-invasive blood pressure, pulse, pulse oximetry, clinical observation of respiration, electrocardiography (ECG) and respiratory frequency measured by the ECG)
Slagelse C, Vilmann P, Hornslet P, Jørgensen HL, Horsted TI. The role of capnography in endoscopy patients undergoing nurse-administered propofol sedation: a randomized study. Scand J Gastroenterol. 2013 Oct;48(10):1222-30. doi: 10.3109/00365521.2013.830327. Epub 2013 Sep 2.

*   Includes publications given by the data provider as well as publications identified by ClinicalTrials.gov Identifier (NCT Number) in Medline.
 
Completed
591
March 2011
February 2011   (Final data collection date for primary outcome measure)

Inclusion Criteria:

  • aged 18 or above
  • compliant with the criteria of NAPS.

Exclusion Criteria:

  • no signed written consent obtained
  • American Society of Anaesthesiologists (ASA) physical status classification > 3
  • sleep apnoea
  • allergy against soy, eggs and peanuts
  • body Mass Index (BMI) > 35 kg/m2
  • mallampati Score ≥ 4
  • acute gastrointestinal bleeding
  • subileus
  • ventricular retention
  • severe COLD ((30% ≤ FEV1 <50%)
  • failed data collection
Sexes Eligible for Study: All
Child, Adult, Senior
No
Contact information is only displayed when the study is recruiting subjects
Denmark
 
 
NCT01507623
NAPS_CAPNOGRAPHY1
No
Not Provided
Not Provided
Charlotte Slagelse, University Hospital, Gentofte, Copenhagen
University Hospital, Gentofte, Copenhagen
The Ministry of Science, Technology and Innovation, Denmark
Study Director: Peter Vilmann, MD, Prof. Herlev and Gentofte University Hospital, Denmark
Principal Investigator: Charlotte Slagelse, Med. student Gentofte University Hospital, Denmark
University Hospital, Gentofte, Copenhagen
January 2012

ICMJE     Data element required by the International Committee of Medical Journal Editors and the World Health Organization ICTRP