Colonoscopy and sedation in Romania: early experience using a balanced propofol regimen.
The aim of this study was to evaluate if the sedation during colonoscopy is correctly performed in our patients, especially because it is usually performed by residents in anesthesiology.


METHODS
we retrospectively evaluated sedation in all the colonoscopies performed in our Endoscopy Department in 2007, by analyzing the sedation scheme that was used.


RESULTS
974 colonoscopies were evaluated. The following sedation schemes were used in the majority of cases: midazolam+propofol+fentanyl-507 patients (52.1%) and diazepam+propofol+fentanyl-258 patients (26.5%). Propofol (in combination with one or more other agents) was used for sedation in 96.9% of cases. The mean doses of drugs were: propofol 125.2+/-67.7 mg, midazolam 2.29+/-0.84 mg (or diazepam 3.4+/-1.4 mg) and fentanyl 59+/-10 microg. The following complications were observed during sedation for colonoscopy: 6 patients (0.6%) developed hypoxemia, which was managed successfully with supplemental oxygen administration or flumazenil injection; 1 patient (0.1%) suffered a cardiac arrest that was successfully managed. There were no deaths or other complications.


CONCLUSIONS
Propofol, combined with an opioid and a benzodiazepine, was used in approximately 97% of cases. The rate of significant oxygen desaturation was low (0.6%). No fatal complications occurred. The mean doses of propofol used were higher than those from published data, while the doses of midazolam and fentanyl were similar.
Sporea
Ioan
I
Department of Gastroenterology and Hepatology, University of Medicine and Pharmacy, Snagov Str. 13, 300842 Timisoara, Romania. isporea@umft.ro
Popescu
Alina
A
Sandesc
Dorel
D
Bedreag
Ovidiu
O
Asai
Ramona
R
Sirli
Roxana
R
Vernic
Corina
C
Nicolita
Diana
D
Martie
Alina
A
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000701:Analgesics, Opioid / Q000008:administration & dosage; D019162:Anesthetics, Combined / Q000008:administration & dosage* / Q000009:adverse effects; D002983:Clinical Competence; D003113:Colonoscopy / Q000009:adverse effects; D003975:Diazepam / Q000008:administration & dosage; D005283:Fentanyl / Q000008:administration & dosage; D006785:Hospitals, University; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage* / Q000009:adverse effects; D008874:Midazolam / Q000008:administration & dosage; D008875:Middle Aged; D015742:Propofol / Q000008:administration & dosage* / Q000009:adverse effects; D012189:Retrospective Studies; D012383:Romania; D055815:Young Adult
D000701:Analgesics, Opioid; D019162:Anesthetics, Combined; D006993:Hypnotics and Sedatives; D003975:Diazepam; D008874:Midazolam; D005283:Fentanyl; D015742:Propofol