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Safety of nonanesthetist sedation with propofol for outpatient colonoscopy and esophagogastroduodenoscopy.
Endoscopy. 2003 Aug; 35(8):679-82.E

Abstract

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). After an initial dose of 0.5 mg/kg (ASA I-II and age </=70) or 0.25 mg/kg (ASA >III or age >70 years), propofol was titrated in 10 mg boluses to a steady state of sedation by the endoscopy nurse under the endoscopist's supervision. Colonoscopy patients also received 25 mg pethidine (meperidine) and 20 mg butylscopolamine, whereas EGDs were performed with propofol sedation alone, without topical pharyngeal anesthesia. In addition to standard monitoring with pulse oximetry and automated sphygmomanometry, patients were also observed with sidestream capnography or measurement of electrocardiographic impedance changes, providing real-time graphic assessment of respiratory activity. All patients were given oxygen 2 L/min by nasal cannula during the entire procedure.

RESULTS

Mean dosages of 157 mg (range 70-340) and 180 mg (60-400) propofol were administered for colonoscopy and EGD procedures, respectively. No episodes of apnea occurred. The oxygen saturation fell below 90 % for short periods of time in 11 patients (3.7 %). Three patients required a temporary increase in oxygen delivery. No assisted ventilation was necessary. In 22 patients (7.3 %), the mean blood pressure temporarily decreased below 50 mmHg. Two patients received a 500-ml infusion of normal saline.

CONCLUSIONS

Propofol can be safely administered for sedation during colonoscopy and esophagogastroduodenoscopy by nonanesthetists who are familiar with the pharmacological properties and use of this drug.

Authors+Show Affiliations

Gastroenterology Center, Bürgerspital, Solothurn, Switzerland. daniel.kuelling@gmx.chNo affiliation info availableNo affiliation info available

Pub Type(s)

Evaluation Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

12929064

Citation

Külling, D, et al. "Safety of Nonanesthetist Sedation With Propofol for Outpatient Colonoscopy and Esophagogastroduodenoscopy." Endoscopy, vol. 35, no. 8, 2003, pp. 679-82.
Külling D, Rothenbühler R, Inauen W. Safety of nonanesthetist sedation with propofol for outpatient colonoscopy and esophagogastroduodenoscopy. Endoscopy. 2003;35(8):679-82.
Külling, D., Rothenbühler, R., & Inauen, W. (2003). Safety of nonanesthetist sedation with propofol for outpatient colonoscopy and esophagogastroduodenoscopy. Endoscopy, 35(8), 679-82.
Külling D, Rothenbühler R, Inauen W. Safety of Nonanesthetist Sedation With Propofol for Outpatient Colonoscopy and Esophagogastroduodenoscopy. Endoscopy. 2003;35(8):679-82. PubMed PMID: 12929064.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Safety of nonanesthetist sedation with propofol for outpatient colonoscopy and esophagogastroduodenoscopy. AU - Külling,D, AU - Rothenbühler,R, AU - Inauen,W, PY - 2003/8/21/pubmed PY - 2003/12/6/medline PY - 2003/8/21/entrez SP - 679 EP - 82 JF - Endoscopy JO - Endoscopy VL - 35 IS - 8 N2 - 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). After an initial dose of 0.5 mg/kg (ASA I-II and age </=70) or 0.25 mg/kg (ASA >III or age >70 years), propofol was titrated in 10 mg boluses to a steady state of sedation by the endoscopy nurse under the endoscopist's supervision. Colonoscopy patients also received 25 mg pethidine (meperidine) and 20 mg butylscopolamine, whereas EGDs were performed with propofol sedation alone, without topical pharyngeal anesthesia. In addition to standard monitoring with pulse oximetry and automated sphygmomanometry, patients were also observed with sidestream capnography or measurement of electrocardiographic impedance changes, providing real-time graphic assessment of respiratory activity. All patients were given oxygen 2 L/min by nasal cannula during the entire procedure. RESULTS: Mean dosages of 157 mg (range 70-340) and 180 mg (60-400) propofol were administered for colonoscopy and EGD procedures, respectively. No episodes of apnea occurred. The oxygen saturation fell below 90 % for short periods of time in 11 patients (3.7 %). Three patients required a temporary increase in oxygen delivery. No assisted ventilation was necessary. In 22 patients (7.3 %), the mean blood pressure temporarily decreased below 50 mmHg. Two patients received a 500-ml infusion of normal saline. CONCLUSIONS: Propofol can be safely administered for sedation during colonoscopy and esophagogastroduodenoscopy by nonanesthetists who are familiar with the pharmacological properties and use of this drug. SN - 0013-726X UR - https://www.unboundmedicine.com/medline/citation/12929064/Safety_of_nonanesthetist_sedation_with_propofol_for_outpatient_colonoscopy_and_esophagogastroduodenoscopy_ L2 - http://www.thieme-connect.com/DOI/DOI?10.1055/s-2003-41518 DB - PRIME DP - Unbound Medicine ER -