Propofol sedation during endoscopic procedures: how much staff and monitoring are necessary?

Background: Propofol has been shown to be safe for nonanesthetist use during GI endoscopy. However, published studies involved propofol administration by an additional nurse or used specialized patient monitoring or were carried out in tertiary hospitals.

Objective: Considering the downward pressure on reimbursement for endoscopic procedures, we asked how much staff and monitoring is necessary for safe use of propofol.

Patient-controlled analgesia and sedation in gastrointestinal endoscopy.

Variations in pain threshold, drug tolerance, and visceral sensitivity among patients make it difficult to anticipate the appropriate dose of sedation for gastrointestinal endoscopy. Propofol was recently introduced for sedation in endoscopy and has a rapid onset and offset of action, making it an ideal substance for patient-controlled administration. Several controlled trials have demonstrated that during colonoscopy, patient-controlled application of propofol alone or in combination with various opioids is effective,safe, and yields high patient satisfaction.

Safety of nonanesthetist sedation with propofol for outpatient colonoscopy and esophagogastroduodenoscopy.

Background And Study Aims: In our endoscopy service, nonanesthetists administered propofol sedation has been used in more than 8000 procedures during the past 3 years. This study prospectively assessed the safety of propofol sedation in outpatient colonoscopy and esophagogastroduodenoscopy (EGD).

Patients And Methods: A total of 300 consecutive outpatients (mean age 53, range 14-94) were enrolled in the study (139 colonoscopies, 161 EGDs).