title: Propofol, the preferred sedation for screening colonoscopy, is underused. Results of an international survey.
abstract: BACKGROUND
  The use of propofol during colonoscopy has become more widespread. To increase availability while maintaining quality and decreasing costs, European Guidelines have been issued for non-anesthesiologist administration of propofol (NAAP). We aimed to assess the current use of propofol during screening colonoscopy.
  
  
  METHODS
  International survey.
  
  
  RESULTS
  Eighty-four questionnaires were collected from endoscopists practicing in 29 countries. Practices were most often located in high-volume community hospitals (Italy, Belgium, Spain, Netherlands in half cases). An anesthesiologist was regularly present in the Endoscopy Unit of 69.0% survey respondents. In low-risk (ASA classification, 1-2) patients, propofol, benzodiazepine+opioids and benzodiazepine alone were used in 45%, 31% and 14% of screening colonoscopies, respectively. Propofol was associated with the highest endoscopist satisfaction (score on a 10-point visual analogue scale, 9.2±1.2 vs. 5.5±1.9 and 4.7±2.0 for benzodiazepine+opioids and benzodiazepine alone, respectively; P<0.0001). NAAP was used by 29.9% of respondents in 9 countries and approximately two-thirds of other endoscopists would consider implementing NAAP. Main reasons for not considering NAAP implementation were medico-legal issues and cost.
  
  
  CONCLUSIONS
  Propofol provides the highest endoscopist satisfaction but it is used in less than half of screening colonoscopies. Propofol is administered by non-anesthesiologists in one-third of settings; its implementation is foreseen by a majority of endoscopists who do not currently use it.
authors: Department of Medicine, Ruhr University Bochum, Bochum, Germany. ariphaus@web.de
authors: Andrea
authors: A
authors: Riphaus
authors: Carlos
authors: C
authors: Macias-Gomez
authors: Jacques
authors: J
authors: Devière
authors: Jean-Marc
authors: JM
authors: Dumonceau
mesh_terms: D000701:Analgesics, Opioid / Q000008:administration & dosage; D018686:Anesthetics, Intravenous / Q000008:administration & dosage*; D001569:Benzodiazepines / Q000008:administration & dosage; D003113:Colonoscopy; D004363:Drug Utilization / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D015742:Propofol / Q000008:administration & dosage*; D011795:Surveys and Questionnaires
chemical_list: D000701:Analgesics, Opioid; D018686:Anesthetics, Intravenous; D001569:Benzodiazepines; D015742:Propofol