title: Computer-assisted personalized sedation for upper endoscopy and colonoscopy: a comparative, multicenter randomized study.
abstract: BACKGROUND
  The SEDASYS System is an investigational computer-assisted personalized sedation system integrating propofol delivery with patient monitoring to enable endoscopist/nurse teams to safely administer propofol.
  
  
  OBJECTIVE
  To compare the safety and effectiveness of the SEDASYS System to the current standard of care for sedation during routine endoscopic procedures.
  
  
  METHODS
  Nonblinded multicenter randomized comparative study.
  
  
  METHODS
  Four ambulatory surgery centers, 3 endoscopy centers, and 1 academic center in the United States.
  
  
  METHODS
  One thousand American Society of Anesthesiologists physical status class I to III adults undergoing routine colonoscopy or EGD.
  
  
  METHODS
  Sedation with the SEDASYS System (SED) and sedation with each site's current standard of care (CSC; benzodiazepine/opioid combination).
  
  
  METHODS
  Area under the curve of oxygen desaturation was the primary endpoint. Secondary endpoints included patient satisfaction, clinician satisfaction, level of sedation, and patient recovery time.
  
  
  RESULTS
  Four hundred ninety-six patients were randomized to SED and 504 to CSC. Area under the curve of oxygen desaturation was significantly lower for SED (23.6 s·%) than for CSC (88.0 s·%; P = .028). Patients were predominately minimally to moderately sedated in both groups. SED patients were significantly more satisfied than CSC patients (P = .007). Clinician satisfaction was greater with SED than with CSC (P < .001). SED patients recovered faster than CSC patients (P < .001). The incidence of adverse events was 5.8% in the SED group and 8.7% in the CSC group.
  
  
  CONCLUSIONS
  Nonblinded.
  
  
  CONCLUSIONS
  The SEDASYS System could provide endoscopist/nurse teams a safe and effective on-label means to administer propofol to effect minimal to moderate sedation during routine colonoscopy and EGD.
authors.affiliation: Charlottesville Medical Research and Charlottesville Gastroenterology Associates, 325 Winding River Lane, Suite 102, Charlottesville, VA 22911, USA.
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Pambianco
authors.forename: John J
authors.initials: JJ
authors.lastname: Vargo
authors.forename: Ronald E
authors.initials: RE
authors.lastname: Pruitt
authors.forename: Robert
authors.initials: R
authors.lastname: Hardi
authors.forename: James F
authors.initials: JF
authors.lastname: Martin
mesh_terms: D000328:Adult; D000368:Aged; D018686:Anesthetics, Intravenous / Q000008:administration & dosage*; D003113:Colonoscopy / Q000379:methods; D016292:Procedural Sedation / Q000379:methods* / Q000451:nursing; D004305:Dose-Response Relationship, Drug; D004360:Drug Therapy, Computer-Assisted / Q000379:methods*; D016099:Endoscopy, Gastrointestinal / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D005767:Gastrointestinal Diseases / Q000175:diagnosis*; D006801:Humans; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000379:methods*; D015742:Propofol / Q000008:administration & dosage*; D016896:Treatment Outcome; D014481:United States
chemical_list: D018686:Anesthetics, Intravenous; D015742:Propofol