Target-Controlled Sedation with Propofol Infusion for PEG-J Placement in Advanced Parkinson’s Disease: A Prospective Observational Study on Safety and Feasibility

Introduction: The management of sedation during percutaneous endoscopic gastrojejunostomy (PEG-J) placement in patients with advanced Parkinson’s disease (PD) is challenging due to the complex interactions between PD treatment, anesthetic agents, and the disease’s motor and non-motor symptoms. This...

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Main Authors: Janos Szederjesi, Irina Săplăcan, Alexandra Lazăr, Matild Keresztes, Georgiana-Mihaela Muller-Șerban, Jozsef Attila Szasz, Bianca Liana Grigorescu
Format: Article
Language:English
Published: MDPI AG 2025-03-01
Series:Life
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Online Access:https://www.mdpi.com/2075-1729/15/3/492
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author Janos Szederjesi
Irina Săplăcan
Alexandra Lazăr
Matild Keresztes
Georgiana-Mihaela Muller-Șerban
Jozsef Attila Szasz
Bianca Liana Grigorescu
author_facet Janos Szederjesi
Irina Săplăcan
Alexandra Lazăr
Matild Keresztes
Georgiana-Mihaela Muller-Șerban
Jozsef Attila Szasz
Bianca Liana Grigorescu
author_sort Janos Szederjesi
collection DOAJ
description Introduction: The management of sedation during percutaneous endoscopic gastrojejunostomy (PEG-J) placement in patients with advanced Parkinson’s disease (PD) is challenging due to the complex interactions between PD treatment, anesthetic agents, and the disease’s motor and non-motor symptoms. This study evaluates the effectiveness and safety of a target-controlled infusion (TCI) propofol protocol in the context of PEG-J placement in advanced PD patients. Materials and Methods: This prospective study included 169 patients diagnosed with advanced Parkinson’s disease (Hoehn and Yahr stages 4 and 5) who underwent PEG-J placement at Târgu Mureș County Emergency Clinical Hospital, Romania. Sedation was induced and maintained using TCI propofol, with additional benzodiazepines and short-acting opioids, while muscle relaxants were not used. Procedural success rates and adverse outcomes were assessed for 30 days post-procedure. Results: The sedation protocol demonstrated a high procedural success rate. No deaths were reported within 30 days post-procedure. Conclusion: This study highlights the feasibility and clinical applicability of a TCI propofol protocol for PEG-J placement in patients with advanced PD (stages 4 and 5). While no deaths were recorded within the 30-day follow-up, the sample size is insufficient to draw definitive conclusions regarding long-term safety.
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spelling doaj-art-b2dda6bc664b4200a8bb5eae1419ab222025-08-20T02:42:25ZengMDPI AGLife2075-17292025-03-0115349210.3390/life15030492Target-Controlled Sedation with Propofol Infusion for PEG-J Placement in Advanced Parkinson’s Disease: A Prospective Observational Study on Safety and FeasibilityJanos Szederjesi0Irina Săplăcan1Alexandra Lazăr2Matild Keresztes3Georgiana-Mihaela Muller-Șerban4Jozsef Attila Szasz5Bianca Liana Grigorescu6Department of Intensive Care, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Târgu-Mureș, 540139 Târgu Mureș, RomaniaDepartment of Intensive Care, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Târgu-Mureș, 540139 Târgu Mureș, RomaniaDepartment of Intensive Care, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Târgu-Mureș, 540139 Târgu Mureș, RomaniaDepartment of Intensive Care, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Târgu-Mureș, 540139 Târgu Mureș, RomaniaDepartment of Intensive Care, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Târgu-Mureș, 540139 Târgu Mureș, Romania2nd Clinic of Neurology, Târgu Mures, County Emergency Clinical Hospital, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Târgu-Mureș, 540139 Târgu Mureș, RomaniaDepartment of Intensive Care, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Târgu-Mureș, 540139 Târgu Mureș, RomaniaIntroduction: The management of sedation during percutaneous endoscopic gastrojejunostomy (PEG-J) placement in patients with advanced Parkinson’s disease (PD) is challenging due to the complex interactions between PD treatment, anesthetic agents, and the disease’s motor and non-motor symptoms. This study evaluates the effectiveness and safety of a target-controlled infusion (TCI) propofol protocol in the context of PEG-J placement in advanced PD patients. Materials and Methods: This prospective study included 169 patients diagnosed with advanced Parkinson’s disease (Hoehn and Yahr stages 4 and 5) who underwent PEG-J placement at Târgu Mureș County Emergency Clinical Hospital, Romania. Sedation was induced and maintained using TCI propofol, with additional benzodiazepines and short-acting opioids, while muscle relaxants were not used. Procedural success rates and adverse outcomes were assessed for 30 days post-procedure. Results: The sedation protocol demonstrated a high procedural success rate. No deaths were reported within 30 days post-procedure. Conclusion: This study highlights the feasibility and clinical applicability of a TCI propofol protocol for PEG-J placement in patients with advanced PD (stages 4 and 5). While no deaths were recorded within the 30-day follow-up, the sample size is insufficient to draw definitive conclusions regarding long-term safety.https://www.mdpi.com/2075-1729/15/3/492Parkinson diseaseTCIanesthesia protocollevodopa–entacapone–carbidopa intestinal gel
spellingShingle Janos Szederjesi
Irina Săplăcan
Alexandra Lazăr
Matild Keresztes
Georgiana-Mihaela Muller-Șerban
Jozsef Attila Szasz
Bianca Liana Grigorescu
Target-Controlled Sedation with Propofol Infusion for PEG-J Placement in Advanced Parkinson’s Disease: A Prospective Observational Study on Safety and Feasibility
Life
Parkinson disease
TCI
anesthesia protocol
levodopa–entacapone–carbidopa intestinal gel
title Target-Controlled Sedation with Propofol Infusion for PEG-J Placement in Advanced Parkinson’s Disease: A Prospective Observational Study on Safety and Feasibility
title_full Target-Controlled Sedation with Propofol Infusion for PEG-J Placement in Advanced Parkinson’s Disease: A Prospective Observational Study on Safety and Feasibility
title_fullStr Target-Controlled Sedation with Propofol Infusion for PEG-J Placement in Advanced Parkinson’s Disease: A Prospective Observational Study on Safety and Feasibility
title_full_unstemmed Target-Controlled Sedation with Propofol Infusion for PEG-J Placement in Advanced Parkinson’s Disease: A Prospective Observational Study on Safety and Feasibility
title_short Target-Controlled Sedation with Propofol Infusion for PEG-J Placement in Advanced Parkinson’s Disease: A Prospective Observational Study on Safety and Feasibility
title_sort target controlled sedation with propofol infusion for peg j placement in advanced parkinson s disease a prospective observational study on safety and feasibility
topic Parkinson disease
TCI
anesthesia protocol
levodopa–entacapone–carbidopa intestinal gel
url https://www.mdpi.com/2075-1729/15/3/492
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