Year 2020 / Volume 112 / Number 10
Original
Randomized clinical trial to assess the mPADSS scale in recovery and home discharge after endoscopy

762-767

DOI: 10.17235/reed.2020.6420/2019

Marina de Benito Sanz, Sara Martínez de la Torre, M.ª Almudena Salvador de las Heras, Raquel Calleja Carbajosa, Patricia Virginia Sesma Fernández, Lourdes Pérez Sierra, Francisco Javier García-Alonso, Manuel Perez-Miranda,

Abstract
Background: current clinical practice guidelines recommend the use of objective scales as a criterion for post-endoscopy sedation discharge. Objective: to assess the recovery time, complications and patient satisfaction level using the mPADSS scale. Material and methods: demographic data and medical history were collected. Vital signs, anxiety and abdominal pain were measured pre-endoscopy. Patients were randomized into a control group, discharged according to the usual practice, and the intervention group, who underwent the mPADSS scale every ten minutes, until an objective score was reached. Results: one hundred and eighteen patients were randomized (78 colonoscopies, 32 gastroscopies, three gastro + colonoscopies and 15 endoscopic retrograde cholangiopancreatographies/endoscopic ultrasound [ERCP/USE]). With regard to medical history, there were 36 cases of elevated blood pressure and 19 diabetes cases, 15 with anticoagulant/antiplatelet and 21 with hypnotic/anxiolytic medication. An average of 160 mg of propofol was required per patient, with additional flumazenil and midazolam in 49. There were two episodes of vomiting and three of mild desaturation, all of them in the control group. Sixty patients were included in the control group and 58 in the mPADSS group, who were discharged in 15 and 10 minutes on average respectively (p < 0.005); 24-48h telephone call follow-up data were available for 105 subjects. There were four readmissions (three control and one mPADSS). There were no differences in pain and post-sedation symptoms and the level of satisfaction in terms of attention and duration of stay was similar in both groups. Conclusions: this study shows the efficiency, safety and patient satisfaction using the mPADSS scale. Thus, its use is recommend.
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References
1. Igea F, Casellas JA, González-Huix F, et al. Sedación en endoscopia digestiva. Guía de práctica clínica de la Sociedad Española de Endoscopia Digestiva. Rev Esp Enfermedades Dig. 2014; 106:195-211.
2. Aldrete JA. The post-anesthesia recovery score revisited. Journal of Clinical Anesthesia. 1995; 7:89-91.
3. Chung F, Chan VWS, Ong D. A Post-Anesthetic Discharge Scoring System for home readiness after ambulatory surgery. J Clin Anesth. 1995; 7:500-6
4. Forceville X, Oxeda C, Leloup E, et al. Peut-on éviter la faute pénale en réalisant une anesthésie ambulatoire? Cah d´anesthesiologie. 1991; 39:427-33.
5. Vayre P, Jost JL. Implications médico-legales de la chirurgie ambulatoire. Implications médico-legales de la chirurgie ambulatoire. Chir - Mem l’Academie Chir. 1993; 119:137-40.
6. Downie WW, Leatham PA, Rhind VM. Studies with pain rating scales. - PubMed - NCBI. Ann Rheum Dis. 1978; 37:378-81.
7. Maestro-Antolín S, Moreira-Da-Silva B, Santos-Santamarta F,et al. Severe cardiorespiratory complications derived from propofol sedation monitored by an endoscopist. Rev Esp Enfermedades Dig. 2018; 110(4): 237-9.
8. Hernán Ocaña P. Sedation assisted by an endoscopist (SAE) for complex endoscopic procedures. Is it time to change the current guidelines? Rev Esp Enfermedades Dig.2018; 110(4): 261-2.
9. López-Muñoz C, Sánchez-Yagüe A, Canca-Sánchez JC, et al.. Quality of sedation with propofol administered by non-anesthetists in a digestive endoscopy unit: The results of a one year experience. Rev Esp Enfermedades Dig. 2018; 110(4): 231-6.
10. Trevisani L. Post-Anaesthetic Discharge Scoring System to assess patient recovery and discharge after colonoscopy. World J Gastrointest Endosc. 2013; 5(10): 502-7.
11. Ead H. From Aldrete to PADSS: Reviewing Discharge Criteria After Ambulatory Surgery. J Perianesthesia Nurs. 2006; 22(2): 154.
12. Amornyotin S, Chalayonnavin W, Kongphlay S. Recovery pattern and home-readiness after ambulatory gastrointestinal endoscopy. J Med Assoc Thail. 2007; 90: 2352-8.
13. González-Santiago JM, Martín-Noguerol E, Vinagre-Rodríguez G, Hernández-Alonso M, Dueñas-Sadornil C, Pérez-Gallardo B, et al. Intermittent boluses versus pump continuous infusion for endoscopist-directed propofol administration in colonoscopy. Rev Esp Enfermedades Dig. 2013; 105:378-84.
14. Cabello E, Estepa L, et al. Evaluación de la escala MPADSS al alta domiciliaria en colonoscopias. Enferm Endosc Dig.2015; 2(2): 28–32.
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de Benito Sanz M, Martínez de la Torre S, Salvador de las Heras M, Calleja Carbajosa R, Sesma Fernández P, Pérez Sierra L, et all. Randomized clinical trial to assess the mPADSS scale in recovery and home discharge after endoscopy. 6420/2019


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Publication history

Received: 01/06/2019

Accepted: 19/01/2020

Online First: 21/09/2020

Published: 07/10/2020

Article revision time: 217 days

Article Online First time: 478 days

Article editing time: 494 days


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