title: Safety of propofol administered by registered nurses with gastroenterologist supervision in 2000 endoscopic cases.
abstract: OBJECTIVE
  Propofol has certain advantages over benzodiazepines plus narcotics as sedation for endoscopy. In a few centers, propofol has reportedly been used in endoscopic procedures and administered by nurses supervised by gastroenterologists without attendance by anesthesiologists or nurse anesthetists.
  
  
  METHODS
  As part of our continuous quality improvement program, we prospectively recorded the doses of propofol and adverse reactions to the drug in our initial 2000 cases. In all cases propofol was administered by nurses who were supervised by gastroenterologists, with no involvement by an anesthesia specialist.
  
  
  RESULTS
  The 2000 cases included 2222 procedures. There were five episodes of oxygen desaturation to <85%, four of which seemed to be related to excessive administration of propofol and were treated by brief (< 1 min) periods of mask ventilation. No patient required endotracheal intubation or hospital admission, or suffered long-term sequelae from propofol administration. There were no perforations in 977 colonoscopies.
  
  
  CONCLUSIONS
  Propofol can be given safely by appropriately trained nurses under supervision by endoscopists. Technology that allows immediate detection of apnea would likely further improve its safety.
authors.affiliation: Indiana University Hospital, Indianapolis 46202, USA.
authors.forename: Douglas K
authors.initials: DK
authors.lastname: Rex
authors.forename: Chris
authors.initials: C
authors.lastname: Overley
authors.forename: Karen
authors.initials: K
authors.lastname: Kinser
authors.forename: Michelle
authors.initials: M
authors.lastname: Coates
authors.forename: Annie
authors.initials: A
authors.lastname: Lee
authors.forename: Brody W
authors.initials: BW
authors.lastname: Goodwine
authors.forename: Eloise
authors.initials: E
authors.lastname: Strahl
authors.forename: Suzanne
authors.initials: S
authors.lastname: Lemler
authors.forename: Brian
authors.initials: B
authors.lastname: Sipe
authors.forename: Emad
authors.initials: E
authors.lastname: Rahmani
authors.forename: Debra
authors.initials: D
authors.lastname: Helper
mesh_terms: D018686:Anesthetics, Intravenous / Q000008:administration & dosage* / Q000009:adverse effects*; D004724:Endoscopy; D005762:Gastroenterology; D006801:Humans; D009726:Nurses; D010820:Physicians; D015742:Propofol / Q000008:administration & dosage* / Q000009:adverse effects*; D011446:Prospective Studies; D017749:Total Quality Management
chemical_list: D018686:Anesthetics, Intravenous; D015742:Propofol