title: Patient maintained sedation for colonoscopy using a target controlled infusion of propofol.
abstract: In this study, we evaluated safety and recovery using a patient maintained, target controlled infusion of propofol for sedation in 20 patients undergoing colonoscopy. Using a handset with a two-minute lockout interval, patients could make 0.2 micro g.ml(-1) increments to an initial target plasma concentration of 1 micro g.ml(-1) up to a maximum 4.5 micro g.ml(-1). Four patients became oversedated but required no airway or circulatory interventions. Subjects had a significant reduction in mean (SD) heart rate: 78.7 (15) vs. 69.8 (13.5) (p < 0.001) and in systolic blood pressure 121.1 (13.2) mmHg vs. 96.5 (8.6) mmHg (p < 0.001). Choice reaction time testing 15 min after colonoscopy showed a significant median (IQR [range]) rise of 162 (- 16, 383.3 [-199-859]) ms (p < 0.05). Six patients had faster reaction times postcolonoscopy. All patients denied unpleasant recall and were satisfied with the system. Although oversedation was a problem in this model, we conclude that patient maintained propofol sedation could be possible for colonoscopy.
authors.affiliation: Department of Anaesthetics, The Royal Sussex County Hospital, Eastern Road, Brighton, BN2 5BE, UK. lynne@camp67.freeserve.co.uk
authors.forename: L
authors.initials: L
authors.lastname: Campbell
authors.forename: G
authors.initials: G
authors.lastname: Imrie
authors.forename: P
authors.initials: P
authors.lastname: Doherty
authors.forename: C
authors.initials: C
authors.lastname: Porteous
authors.forename: K
authors.initials: K
authors.lastname: Millar
authors.forename: G N C
authors.initials: GN
authors.lastname: Kenny
authors.forename: G
authors.initials: G
authors.lastname: Fletcher
mesh_terms: D000328:Adult; D000368:Aged; D001794:Blood Pressure / Q000187:drug effects; D003113:Colonoscopy; D016292:Procedural Sedation / Q000379:methods*; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D010865:Pilot Projects; D015742:Propofol / Q000008:administration & dosage*; D011930:Reaction Time / Q000187:drug effects; D012646:Self Administration
chemical_list: D006993:Hypnotics and Sedatives; D015742:Propofol