The effect of propofol for conscious sedation during colonoscopy-A Prospective, Randomized Study

Cho, Hoon; Kim, Yeong Muk; Oh, Ji Hyeon; Jeon, Su Jin; Moon, Jae Hyeon; Kim, Min Hee; Park, Keum Mi; Lee, Joon Sang

Abstract

BACKGROUND: The objectives of this study were to assess propofol as sedative agents for colonoscopy in the safety and efficacy, compared with midazolam plus meperidine.
METHODS
120 patients undergoing colonoscopy in a prospective study were randomly assigned to one of three medication regimens. Patients in group A (n=42) received i.v. 25 mg of meperidine and 2.5 mg of midazolam. Patients in group B (n=41) received i.v. a median dose of 96.59 mg of propofol (range 40-180) and patients in group C (n=37) received i.v. 25 mg of meperidine and a median dose of 77.03 mg of propofol (range 40-150), administered by a nurse with endoscopist supervision. Endpoints were patient satisfaction, procedure and recovery times and complications.
RESULTS
The mean time to sedation was much faster in 2 groups using propofol (group A: 152+/-105.9 sec, group B: 52.9+/-46.5 sec, group C: 56+/-63.7sec; p<0.001). The mean time to reach the cecum was not different among the 3 groups. There were total 3 episodes of oxygen desaturation to <90%, as one in each group, but the patients were spontaneously recovered with only increasing O2 concentration and arousal. Patients in group C expressed better overall mean satisfaction than patients in group A (p=0.049), but difference was not found between group A and group B. The amnestic effect was better in two groups using propofol than group A (p=0.017) The mean dose of propofol was lower in the patients who received propofol combined with low dose of meperidine than those with propofol only (77.03 mg vs 96.59 mg, p=0.009).
CONCLUSION
Nurse-administered propofol sedation with endoscopist supervision is believed to be safe and useful for colonoscopy with careful monitoring.