[Use of propofol administered by nurse for the sedation during coloscopies in a national hospital in Lima - Peru].
BACKGROUND
Propofol is becoming a widely used drug in patient sedation for patients that undergo endoscopic procedures. There are no reports on the use of propofol in public hospitals in Peru.


OBJECTIVE
To describe our experience in propofol use in colonoscopies performed at Hospital Nacional Cayetano Heredia administered by a dedicated nurse with clinical and pulse oximetry monitorization in procedures performed by gastroenterologists and in-training residents of gastroenterology.


METHODS
An observational and prospective study was performed at the Gastroenterology unit of Hospital Nacional Cayetano Heredia from Lima, Peru from January 2007 to April 2008. Patients were chosen on arrival to get an appointment for colonoscopy provided they did not have any exclusion criteria. Midazolam and meperidine IV premedication was administered prior to attack dose administration of propofol followed by boluses administered according to the nurse and physician assessment of the patient's pulse oximetry, ventilation, sedation and tolerance to the procedure.


RESULTS
163 colonoscopies were performed. Medium dose of propofol was 89.51mg (range 30mg - 220mg). 5,5% of patients had oxygen saturation less than 90% during the procedure but none required mask ventilation. There were no other complications. Procedure was performed by a gastroenterologist and by an in-training resident of gastroenterology. The same and only nurse was in charge of sedation in every procedure. Sedation degree achieved by patients in SAS scale (sedation agitation scale) was 3 (Sedated) in 66,26% and 4 (Calm and cooperative) in 29,45%. No patient had scales 1 (unarousable), 6 (very agitated) or 7 (dangerous agitation).


CONCLUSIONS
Propofol sedation can be safely administered by a trained nurse with only pulse oximetry and clinical monitorization in colonoscopies performed by gastroenterologist as well as in-training residents of gastroenterology, being a very comfortable procedure both for patients and endoscopists.
Zevallos
Elizabeth Refulio
ER
Enfermera del servicio de gastroenterologia del Hospital Nacional Cayetano Heredia, Lima, Peru. elicrz2006@yahoo.es
Tenorio
Jorge Huerta-Mercado
JH
Ríos
Jorge Espinoza
JE
Valdivia
Jose Pinto
JP
De Los Rios Senmache
Raul
R
Rivera
Alejandro Piscoya
AP
Gutierrez
Sandro Vila
SV
Encinas
Carlos Garcia
CG
Rivera
Alejandro Bussalleu
AB
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003113:Colonoscopy / Q000451:nursing*; D016292:Procedural Sedation / Q000451:nursing*; D005260:Female; D006761:Hospitals; D006801:Humans; D006993:Hypnotics and Sedatives / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D010568:Peru; D015742:Propofol / Q000627:therapeutic use*; D011446:Prospective Studies; D055815:Young Adult
D006993:Hypnotics and Sedatives; D015742:Propofol