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Propofol alone titrated to deep sedation versus propofol in combination with opioids and/or benzodiazepines and titrated to moderate sedation for colonoscopy.
Am J Gastroenterol. 2006 Oct; 101(10):2209-17.AJ

Abstract

BACKGROUND

Propofol by nonanesthesiologists is controversial because the drug is commonly used to produce deep sedation or general anesthesia. Propofol in combination with opioids and/or benzodiazepines can be titrated to moderate sedation, which might be safer.

AIM

To compare recovery time, patient satisfaction, and other end points with propofol alone titrated to deep sedation versus propofol combination therapy with opioids and/or benzodiazepines.

METHOD

A randomized controlled clinical trial of propofol alone titrated to deep sedation versus fentanyl plus propofol versus midazolam plus propofol versus fentanyl plus midazolam plus propofol in 200 outpatients undergoing colonoscopy. Each combination regimen was titrated to moderate sedation.

RESULTS

Patients receiving propofol alone received higher doses of propofol and had deeper sedation scores compared with combination therapy (both p < 0.001). Patients receiving combination regimens were discharged more quickly (median 13.0-14.7 versus 18.1 min) than those receiving propofol alone (p < 0.01). There were no differences in vital signs or oxygen saturations among the study arms. There were no significant differences in pain or satisfaction among the study arms in the recovery area. At a follow-up phone call, patients receiving fentanyl and propofol remembered more of the procedure than those in the other regimens (p < 0.005) and remembered more pain than those receiving propofol alone (p < 0.02).

CONCLUSIONS

Propofol in combination with fentanyl and/or midazolam can be titrated to moderate levels of sedation without substantial loss of satisfaction and with shorter recovery times compared with propofol titrated to deep sedation throughout the procedure.

Authors+Show Affiliations

Department of Medicine, Division of Gastroenterology, Indiana University School of Medicine, Indianapolis Indiana 46202, USA.No affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

17032185

Citation

VanNatta, Megan E., and Douglas K. Rex. "Propofol Alone Titrated to Deep Sedation Versus Propofol in Combination With Opioids And/or Benzodiazepines and Titrated to Moderate Sedation for Colonoscopy." The American Journal of Gastroenterology, vol. 101, no. 10, 2006, pp. 2209-17.
VanNatta ME, Rex DK. Propofol alone titrated to deep sedation versus propofol in combination with opioids and/or benzodiazepines and titrated to moderate sedation for colonoscopy. Am J Gastroenterol. 2006;101(10):2209-17.
VanNatta, M. E., & Rex, D. K. (2006). Propofol alone titrated to deep sedation versus propofol in combination with opioids and/or benzodiazepines and titrated to moderate sedation for colonoscopy. The American Journal of Gastroenterology, 101(10), 2209-17.
VanNatta ME, Rex DK. Propofol Alone Titrated to Deep Sedation Versus Propofol in Combination With Opioids And/or Benzodiazepines and Titrated to Moderate Sedation for Colonoscopy. Am J Gastroenterol. 2006;101(10):2209-17. PubMed PMID: 17032185.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Propofol alone titrated to deep sedation versus propofol in combination with opioids and/or benzodiazepines and titrated to moderate sedation for colonoscopy. AU - VanNatta,Megan E, AU - Rex,Douglas K, PY - 2006/10/13/pubmed PY - 2006/12/21/medline PY - 2006/10/13/entrez SP - 2209 EP - 17 JF - The American journal of gastroenterology JO - Am J Gastroenterol VL - 101 IS - 10 N2 - BACKGROUND: Propofol by nonanesthesiologists is controversial because the drug is commonly used to produce deep sedation or general anesthesia. Propofol in combination with opioids and/or benzodiazepines can be titrated to moderate sedation, which might be safer. AIM: To compare recovery time, patient satisfaction, and other end points with propofol alone titrated to deep sedation versus propofol combination therapy with opioids and/or benzodiazepines. METHOD: A randomized controlled clinical trial of propofol alone titrated to deep sedation versus fentanyl plus propofol versus midazolam plus propofol versus fentanyl plus midazolam plus propofol in 200 outpatients undergoing colonoscopy. Each combination regimen was titrated to moderate sedation. RESULTS: Patients receiving propofol alone received higher doses of propofol and had deeper sedation scores compared with combination therapy (both p < 0.001). Patients receiving combination regimens were discharged more quickly (median 13.0-14.7 versus 18.1 min) than those receiving propofol alone (p < 0.01). There were no differences in vital signs or oxygen saturations among the study arms. There were no significant differences in pain or satisfaction among the study arms in the recovery area. At a follow-up phone call, patients receiving fentanyl and propofol remembered more of the procedure than those in the other regimens (p < 0.005) and remembered more pain than those receiving propofol alone (p < 0.02). CONCLUSIONS: Propofol in combination with fentanyl and/or midazolam can be titrated to moderate levels of sedation without substantial loss of satisfaction and with shorter recovery times compared with propofol titrated to deep sedation throughout the procedure. SN - 0002-9270 UR - https://www.unboundmedicine.com/medline/citation/17032185/Propofol_alone_titrated_to_deep_sedation_versus_propofol_in_combination_with_opioids_and/or_benzodiazepines_and_titrated_to_moderate_sedation_for_colonoscopy_ L2 - https://Insights.ovid.com/pubmed?pmid=17032185 DB - PRIME DP - Unbound Medicine ER -