Effect-site targeted patient-controlled sedation with propofol: comparison with anaesthetist administration for colonoscopy.
Patient-controlled sedation (PCS) allows patients to match their sedation requirement to perceived discomfort. The significant delay in onset of sedation may be overcome with effect-site steered target controlled infusion, but previously only trials in volunteers have been carried out. We therefore conducted a randomised, double-blind controlled trial comparing effect-site steered propofol PCS with anaesthetist-administered propofol sedation in 40 patients presenting for colonoscopy. The initial effect-site target in the PCS group was 0.8 microg.ml(-1), increment was 0.1 microg.ml(-1) and lockout was 3 min. Patient and endoscopist satisfaction and operating conditions were similar between the two groups. PCS patients were sedated more slowly (13 [7.1] vs. 3 [1.1] min; p < 0.0001) and less deeply (minimum BIS value: 71 [16] vs. 58 [15]; p = 0.13) than anaesthetist-administered propofol sedation patients. More of the latter patients were hypotensive, but all patients had similar recollection of events during the procedure and similar quality of recovery.
Stonell
C A
CA
Research Fellow, 2 Head of Research, Department of Anaesthesia and Pain Management, Royal Melbourne Hospital, Australia.
Leslie
K
K
Absalom
A R
AR
D000293:Adolescent; D000328:Adult; D000368:Aged; D003113:Colonoscopy; D016292:Procedural Sedation / Q000379:methods*; D003243:Consciousness; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement / Q000379:methods; D017060:Patient Satisfaction; D015742:Propofol / Q000008:administration & dosage*; D012646:Self Administration
D006993:Hypnotics and Sedatives; D015742:Propofol