USE OF DIPRIVAN(R) FOR ENDOSCOPIES OF THE GASTROINTESTINAL-TRACT

After evaluation of the patient's clinical condition and appropriate p remedication is seems reasonable to suggest for: 1. Endoscopic procedu res involving the gastro-intestinal tract: - slow, titrated induction, using 0.5 to 1 mg . kg-1 of propofol, until the required level of sed ation has been achieved; - this may or not be preceded by the injectio n of a low dose of midazolam (0.02 to 0.03 mg . kg-1) or of alfentanil (5 mug . kg-1); - maintenance is achieved by bolus injections of 20 m g (up to 0.5 mg . kg-1); - maintenance of spontaneous ventilation, wit h oxygen administration is the rule; - Spo2 is monitored routinely; - anaesthesia has to be performed according to the recommendations of th e French Society of Anaesthesia and Intensive Care (SFAR) and the anae sthetist must be prepared to manage any incident during the endoscopy and the recovery period. 2. Procedures involving the biliary tract and the oesophagus, which require deeper anaesthesia: - induction should again be titrated using a very slow infusion, with doses ranging from 0.9 to 2.2 mg . kg-1); - the maintenance requires a continuous infusio n, doses ranging from 4 to 6 mg . kg-1 . h-1 when propofol is administ ered alone and from 4 to 12 mg . kg-1 . h-1 when combined with an opio id; - continuous oxygenation is necessary using a nasal airway; the ne ed for intubation depends on the type of procedure and the status of t he patient; - the same monitoring devices and similar safety measures are required during and after procedure as for any anaesthetic or seda tion, especially when it is performed in day-case patients or outside the operating theatre.