Safety of sodium phosphate tablets in patients receiving propofol-based sedation for colonoscopy.
OBJECTIVE
To compare the incidence of peri-procedure adverse events in patients undergoing colon cleansing with sodium phosphate tablets or polyethylene glycol solution prior to colonoscopy with propofol-based sedation.


BACKGROUND
Propofol is a rapidly acting hypnotic sedative general anesthetic agent increasingly being used for colonoscopy. Although traditionally patients fast overnight prior to a general anesthetic, a new Food and Drug Administration-approved sodium phosphate tablet purgative requires ingestion of 20 tablets with 56 ounces of clear liquid 3 to 5 hours prior to colonoscopy.


METHODS
We retrospectively reviewed 97 outpatients who received propofol-based sedation for colonoscopy. This was a subset of a randomized, investigator-blinded, multicenter trial comparing sodium phosphate tablets with polyethylene glycol. Study data and anesthesia records were reviewed for peri-procedure hemodynamic, cardiac, and pulmonary adverse events as well as the need for hospital admission.


RESULTS
There were no statistically significant differences between the 2 groups when analyzed for the development of tachycardia, decrease in mean arterial pressure below 50 mmHg, or a reduction in the mean arterial pressure greater than 30% from the pre-procedure value. No patients in either group experienced hypoxia (oxygen saturation < 90%), excessive regurgitation, pneumonia, or hospital admission.


CONCLUSIONS
Peri-procedure adverse events occurred rarely and with no increased frequency in patients using the sodium phosphate tablet purgative and receiving propofol-based sedation. The sodium phosphate tablet purgative is safe for patients receiving propofol-based sedation for colonoscopy.
Eschinger
Eric J
EJ
Thomas Jefferson University, Philadelphia, PA 19107, USA.
Littman
Jeffrey J
JJ
Meyer
Kimberly
K
Katz
Leo C
LC
Milman
Perry J
PJ
Kastenberg
David M
DM
D000368:Aged; D001794:Blood Pressure / Q000187:drug effects; D002400:Cathartics / Q000009:adverse effects / Q000494:pharmacology* / Q000627:therapeutic use; D003113:Colonoscopy; D016292:Procedural Sedation / Q000379:methods; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000009:adverse effects / Q000494:pharmacology* / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D010710:Phosphates / Q000009:adverse effects / Q000494:pharmacology* / Q000627:therapeutic use; D015742:Propofol / Q000009:adverse effects / Q000494:pharmacology* / Q000627:therapeutic use; D012189:Retrospective Studies; D016037:Single-Blind Method; D013607:Tablets; D013610:Tachycardia / Q000139:chemically induced; D016896:Treatment Outcome
D002400:Cathartics; D006993:Hypnotics and Sedatives; D010710:Phosphates; D013607:Tablets; C018279:sodium phosphate; D015742:Propofol