Safety and effectiveness of propofol sedation during and after outpatient colonoscopy.
OBJECTIVE
To study the safety and effectiveness of propofol sedation for outpatient colonoscopy.


METHODS
Propofol was given by bolus injection with an age-adjusted standard protocol consisting of 60 mg for patients < 70 years old, 40 mg for patients age 70-89 years, and 20 mg for those ≥ 90 years, and additional injections of 20 mg propofol were given up to a maximum of 200 mg. The principal parameters were the occurrence of adverse events within 24 h after colonoscopy and overall satisfaction for this procedure. Secondary parameters included successful procedure, respiratory depression, and other complications.


RESULTS
Consecutive patients were entered prospectively and all 2101 entered successfully completed outpatient colonoscopy. The mean dose of propofol used was 96.4 mg (range 40-200 mg). Younger patients required higher doses of propofol than older patients (20-40 years vs ≥ 61 years: 115.3 ± 32 mg vs 89.7 ± 21 mg, P < 0.001). Transient supplemental oxygen supply was needed by five patients (0.2%); no other complications occurred. The questionnaires were completed by 1820 (87%) of 2101 patients and most rated their overall satisfaction as excellent (80%) or good (17%). The majority (65%) of patients drove home or to their office after their colonoscopy. Most (99%) were willing to repeat the same procedure. No incidents occurred within 24 h after colonoscopy.


CONCLUSIONS
Propofol sedation using a dose < 200 mg proved both safe and practical for outpatient colonoscopy.
Digestive Disease Center, Showa Inan General Hospital, Komagane 399-4117, Japan. horiuchi.akira@sihp.jp
Akira
A
Horiuchi
Yoshiko
Y
Nakayama
Masashi
M
Kajiyama
Naoyuki
N
Kato
Tetsuya
T
Kamijima
Yasuyuki
Y
Ichise
Naoki
N
Tanaka
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D018686:Anesthetics, Intravenous / Q000627:therapeutic use*; D003113:Colonoscopy / Q000379:methods*; D016292:Procedural Sedation / Q000379:methods; D004724:Endoscopy / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010045:Outpatients; D010100:Oxygen / Q000737:chemistry; D015742:Propofol / Q000627:therapeutic use*; D011446:Prospective Studies
D018686:Anesthetics, Intravenous; D010100:Oxygen; D015742:Propofol