***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
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    ***EXAMPLES*** 
    Input: Background This prospect i ve and r and omized study was design ed to compare safety , potential complications , and patient and examiner satisfaction of 2 anesthetic combinations – etomi date -remifentanil and propofol-remifentanil – in elderly patients undergoing diagnostic gastroscopy . Material / Methods A group of 720 patients , aged 60–80 years , scheduled for diagnostic gastroscopy under sedation were prospect ively r and omized . After 0.4–0.6 μg kg−1 of remifentanil was infused , etomi date or propofol was administered . Patients in the etomi date group received doses of etomi date at 0.1–0.15 mg kg−1 followed by 4–6 mg . Patients in the propofol group received doses of propofol at 1–2 mg kg−1 followed by 20–40 mg . Physiological indexes were evaluated for the 715 of 720 patients that completed the treatment . The onset time , duration time , and discharge time were recorded . Physicians , anesthetists , and patients were surveyed to assess their satisfaction . Results Systolic pressure and diastolic pressure decreased significantly after the procedure in the propofol group ( P<0.001 ) . The average heart rate was significantly lower in the propofol group ( P<0.05 ) . No periods of desaturation ( SpO2 < 95 % ) were observed in either group . The onset time was earlier in the etomi date group ( P=0.00 ) . All adverse events , with the exception of myoclonus , were greater in the propofol group , and physician and patient satisfaction in both groups was similar . Conclusions Etomi date -remifentanil administration for sedation and analgesia during gastroscopy result ed in more stable hemodynamic responses and less adverse events in older patients Objective The aim of the study was to compare haemodynamic responses , recovery and discharge times , and physician satisfaction of etomi date –remifentanil and propofol – remifentanil combinations in patients undergoing elective colonoscopy . Methods Sixty patients , aged 18–65 years , scheduled for elective colonoscopy under sedation were prospect ively r and omized , double blind for the study . Two minutes after the beginning of a continuous remifentanil infusion ( 0.1 μg kg−1 min−1 ) , etomi date or propofol were administered . Patients in the etomi date group received a 0.05 mg kg−1 maintenance dose of etomi date after an initial dose of 0.1 mg kg−1 , and patients in the propofol group received a 0.25 mg kg−1 maintenance dose of propofol after an initial dose of 0.5 mg kg−1 in order to have a Ramsay sedation score of 3–4 . Basal values of heart rate , mean arterial pressure , oxygen saturation , respiratory rate and Ramsay sedation score were recorded . Values were recorded every 2 min for the first 10 min and every 5 min thereafter , until the completion of the procedure . Results Mean arterial pressure was lower at 4 , 6 , 8 , 10 , 15 , 20 and 25 min in the propofol group ( P = 0.001 ) . Mean respiratory rate in the propofol group at 6 , 8 , 10 , 15 , 20 , 25 min was also lower ( P < 0.05 ) . The incidence of apnoea and hypotension was significantly lower in the etomi date group ( P < 0.001 ) . Arrival time into the postoperative care unit and recovery time were shorter in the etomi date group ( P = 0.001 , P = 0.01 , respectively ) . Physician satisfaction in both groups was similar . Conclusion Etomi date –remifentanil administration for sedation and analgesia during colonoscopy result ed in more stable haemodynamic responses and shorter recovery and discharge times The aim of the present study is to compare the safety , efficacy and cost effectiveness of anesthetic regimens by compound , using etomi date and propofol in elderly patients undergoing gastroscopy . A total of 200 volunteers ( 65 - 79 years of age ) scheduled for gastroscopy under anesthesia were r and omly divided into the following groups : P , propofol ( 1.5 - 2.0 mg/kg ) ; E , etomi date ( 0.15 - 0.2 mg/kg ) ; P+E , propofol ( 0.75 - 1 mg/kg ) followed by etomi date ( 0.075 - 0.1 mg/kg ) ; and E+P , etomi date ( 0.075 - 0.01 mg/kg ) followed by propofol ( 0.75 - 1 mg/kg ) . Vital signs and bispectral index were monitored at different time points . Complications , induction and examination time , anesthesia duration , and recovery and discharge time were recorded . At the end of the procedure , the satisfaction of patients , endoscopists and the anesthetist were evaluated . The recovery ( 6.1±1.2 h ) and discharge times ( 24.8±2.8 h ) in group E were significantly longer compared with groups P , P+E and E+P ( P<0.05 ) . The occurrence of injection pain in group P+E was significantly higher compared with the other three groups ( P<0.05 ) . In addition , the incidence of myoclonus and post-operative nausea and vomiting were significantly higher in group P+E compared with the other three groups ( P<0.05 ) . There was no statistical difference among the four groups with regards to the patients ' immediate , post-procedure satisfaction ( P>0.05 ) . Furthermore , there was no difference in the satisfaction of anesthesia , as evaluated by the anesthetist and endoscopist , among the four groups ( P>0.05 ) . The present study demonstrates that anesthesia for gastroscopy in elderly patients can be safely and effectively accomplished using a drug regimen that combines propofol with etomi date . The combined use of propofol and etomi date has unique characteristics which improve hemodynamic stability , cause minimal respiratory depression and less side effects , provide rapid return to full activity and result in high levels of satisfaction Summary Background Endoscopic retro grade cholangiopancreatography ERCP is a painful and long procedure requiring transient deep analgesia and conscious sedation . An ideal anaesthetic that guarantees a rapid and smooth induction , good quality of maintenance , lack of adverse effects and rapid recovery is still lacking . This study aim ed to compare safety and efficacy of a continuous infusion of low dose remifentanil plus ketamine combined with propofol in comparison to the st and ard regimen dose of remifentanil plus propofol continuous infusion during ERCP . Material / Methods 322 ASAI-III patients , 18–85 years old and scheduled for planned ERCP were r and omized . Exclusion criteria were a predictable difficult airway , drug allergy , and ASA IV – V patients . We evaluated Propofol 1 mg/kg/h plus Remifentanil 0.25 μg/kg/min ( GR ) vs. Propofol 1 mg/kg/h plus Ketamine 5 μg/kg/min and Remifentanil 0.1 μg/kg/min ( GK ) . Main outcome measures were respiratory depression , nausea/vomiting , quality of intraoperative conditions , and discharge time . P≤0.05 was statistically significant ( 95 % CI ) . Results Respiratory depression was observed in 25 patients in the GR group compared to 9 patients in the GK group ( p=0.0035 ) . ERCP was interrupted in 9 cases of GR vs. no cases in GK ; patients ventilated without any complication . Mean discharge time was 20±5 min in GK and 35±6 min in GR ( p=0.0078 ) and transfer to the ward delayed because of nausea and vomiting in 30 patients in GR vs. 5 patients in GK ( p=0.0024 ) . Quality of intraoperative conditions was rated highly satisfactory in 92 % of GK vs. 67 % of GR ( p=0.028 ) . Conclusions The drug combination used in GK confers clinical advantages because it avoids deep sedation , maintains adequate analgesia with conscious sedation , and achieves lower incidence of postprocedural nausea and vomiting with shorter discharge times AIM To evaluate the effect of posterior lingual lidocaine swab on  patient tolerance to esophagogastroduodenoscopy  , the ease of performance of the procedure , and to determine if such use will reduce the need for intravenous sedation . METHODS Eighty patients undergoing diagnostic esophagogastroduodenoscopy in a tertiary care medical center were r and omized to either lidocaine swab or spray . Intravenous meperidine and midazolam were given as needed during the procedure . RESULTS Patients in the lidocaine swab group ( SWG ) tolerated the procedure better than those in the spray group ( SPG ) with a median tolerability score of 2 ( 1 , 4 ) compared to 4 ( 2 , 5 ) ( P < 0.01 ) . The endoscopists encountered less difficulty performing the procedures in the SWG with lower median difficulty scores of 1 ( 1 , 5 ) compared to 4 ( 1 , 5 ) in the SPG ( P < 0.01 ) . In addition , the need for intravenous sedation was also lower in the SWG compared to the SPG with fewer patients requiring intravenous sedation ( 13/40 patients vs 38/40 patients , respectively , P < 0.01 ) . The patients in the SWG were more satisfied with the mode of local anesthesia they received as compared to the SPG . In addition , the endoscopists were happier with the use of lidocaine swab . CONCLUSION The use of a posterior lingual lidocaine swab in esophagogastroduodenoscopy improves patient comfort and tolerance and endoscopist satisfaction and decreases the need for intravenous sedation Background and aims Sedation with propofol alone during gastroscopy has many side effects . Etomi date has advantages in terms of circulation and respiration compared to propofol . We hypothesized that etomi date plus propofol during gastroscopy would be more safe and effective than propofol alone . Methods Four hundred ( n = 400 ) patients were r and omly divided into a propofol group ( P group ) and a etomi date plus propofol group ( EP group ) . The P group was given the first dose of 1 % propofol 1 mg/kg before gastroscopy , and the EP group was given 1 % propofol 0.5 mg/kg plus etomi date 0.1 mg/kg . Repeated doses of 10–20 mg propofol or 5–10 mg propofol plus 1–2 mg etomi date were administered to maintain an adequate level of sedation . The sedation depth was maintained by bispectral index value of 40–60 . Results The EP group had a lower incidence of systolic hypotension ( 13.0 vs. 32.5 % ; P < 0.0001 ) , bradycardia ( 8.5 vs. 16.5 % ; P = 0.0226 ) , mild hypoxemia ( 6.5 vs. 18.0 % ; P = 0.0007 ) , and severe hypoxemia ( 2.5 vs. 10.0 % ; P = 0.0031 ) compared to the P group . Also , the satisfaction of anesthetist and gastroscopist with EP was higher than that of P group ( P < 0.0001 ; P = 0.018 , respectively ) . Conclusion Etomi date plus propofol had few effects on respiration and circulation in patients undergoing gastroscopy and was more safe and effective than propofol alone AIM To investigate whether patients with obstructive sleep apnea ( OSA ) are at risk of sedation-related complications during diagnostic esophagogastroduodenoscopy ( EGD ) . METHODS A prospect i ve study was performed in consecutive patients with OSA , who were confirmed with full-night polysomnography between July 2010 and April 2011 . The occurrence of cardiopulmonary complications related to sedation during diagnostic EGD was compared between OSA and control groups . RESULTS During the study period , 31 patients with OSA and 65 controls were enrolled . Compared with the control group , a higher dosage of midazolam was administered ( P = 0.000 ) and a higher proportion of  deep sedation  was performed ( P = 0.024 ) in the OSA group . However , all adverse events , including sedation failure , paradoxical responses , snoring or apnea , hypoxia , hypotension , oxygen or flumazenil administration , and other adverse events were not different between the two groups ( all P > 0.1 ) . Patients with OSA were not predisposed to hypoxia with multivariate logistic regression analysis ( P = 0.068 ) . CONCLUSION In patients with OSA , this limited sized study did not disclose an increased risk of cardiopulmonary complications during diagnostic EGD under sedation Goals In a prospect i ve , double-blind study , we examined the effects of routine sedation and pharyngeal anesthesia on cardiorespiratory parameters during gastroscopy . Background Intravenous sedation and topical pharyngeal anesthesia are used to alleviate the discomfort during upper gastrointestinal endoscopy . Cardiorespiratory changes during gastroscopy are common . Study Two hundred fifty two consecutive out patients undergoing gastroscopy were assigned into 4 groups : ( 1 ) sedation with intravenous midazolam and placebo throat spray ( midazolam group ) , ( 2 ) placebo sedation and phary 
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Conclusions : Between etomi date and propofol , no significant difference was revealed regarding anesthesia duration , recovery time , mean arterial pressure at intubation , heart pulse at intubation , SPO2 at intubation , patient satisfaction , hypotension , changes of heart rate and nausea-vomiting .
Compared with propofol , etomi date showed reduced apnea or hyoxemia , and injection pain , but with an increased myoclonus