Nurse-administered propofol sedation compared with midazolam and meperidine for EUS: a prospective, randomized trial.
BACKGROUND
The utility of nurse-administered propofol sedation (NAPS) compared with midazolam and meperidine (M/M) for EUS is not known.


OBJECTIVE
To compare recovery times, costs, safety, health personnel, and patient satisfaction of NAPS and M/M for EUS.


METHODS
Prospective, randomized, single-blinded trial.


METHODS
Tertiary-referral hospital in Indianapolis, Indiana.


METHODS
Outpatients referred for EUS.


METHODS
Sedation with M/M or NAPS. The patient and recovery nurse were blinded; however, the sedating nurse, endoscopist, and recording research nurse were unblinded to the sedatives used. A capnography, in addition to standard monitoring, was used. A questionnaire and visual analog scale assessed patient, endoscopist, and sedating nurse satisfaction.


METHODS
Recovery times, costs, safety, health personnel, and patient satisfaction in both groups.


RESULTS
Eighty consecutive patients were randomized to NAPS (n = 40) or M/M (n = 40). More patients in the propofol group were current tobacco users; patient demographics, procedures performed, mean procedure length, and the overall frequency of adverse events were otherwise similar. Compared with M/M, NAPS was associated with a faster induction of sedation (2.3 vs 5.7 minutes, respectively; P = .001) and full recovery time (29 vs 49 minutes, respectively; P = .001), higher postprocedure patient satisfaction, and quicker anticipated return to baseline function. At discharge, total costs (recovery plus medications) were similar between the propofol ($406) and M/M groups ($399; P = .79).


CONCLUSIONS
Low-risk patient population.


CONCLUSIONS
Compared with M/M, NAPS for an EUS offered a faster sedation induction and full recovery time, higher postprocedure patient satisfaction, and a quicker anticipated return to baseline function. Total costs were similar between the groups.
Dewitt
John
J
Departments of Gastroenterology and Hepatology, Indiana University Medical Center and Regenstrief Institute, Inc, Indianapolis, Indiana, USA.
McGreevy
Kathleen
K
Sherman
Stuart
S
Imperiale
Thomas F
TF
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care / Q000191:economics; D000762:Anesthesia Recovery Period; D018686:Anesthetics, Intravenous / Q000008:administration & dosage / Q000191:economics; D016292:Procedural Sedation / Q000191:economics / Q000451:nursing*; D003362:Cost-Benefit Analysis; D016099:Endoscopy, Gastrointestinal / Q000191:economics / Q000379:methods; D019160:Endosonography; D005260:Female; D006801:Humans; D008297:Male; D008614:Meperidine / Q000008:administration & dosage* / Q000191:economics; D008874:Midazolam / Q000008:administration & dosage* / Q000009:adverse effects; D008875:Middle Aged; D010146:Pain / Q000517:prevention & control; D010147:Pain Measurement; D011336:Probability; D015742:Propofol; D011446:Prospective Studies; D012016:Reference Values; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D016037:Single-Blind Method; D055815:Young Adult
D018686:Anesthetics, Intravenous; D008614:Meperidine; D008874:Midazolam; D015742:Propofol