title: Propofol for pediatric colonoscopy: the experience of a large, tertiary care pediatric hospital.
abstract: Successful colonoscopy includes full visualization of the terminal ileum, especially in inflammatory bowel disease when ileal biopsy is essential. In children, higher levels of anxiety and lack of cooperation often necessitate a deeper level of sedation. The aim of this study was to evaluate the effectiveness of propofol compared with midazolam and fentanyl for colonoscopy, and in accomplishing ileal and cecal intubation in particular. This was a retrospective cohort study comparing the rates of successful colonoscopy in patients receiving propofol with those receiving midazolam/fentanyl. Complete, successful, colonoscopy to the terminal ileum was achieved in 78% of propofol patients compared with 66% of the midazolam/fentanyl group (P=0.004). Endoscopy reaching the cecum, but not the terminal ileum, was achieved in 78% of propofol patients and 66% of midazolam/fentanyl patients. The use of propofol was associated with a statistically significant increase in the rate of successful colonoscopy reaching the terminal ileum.
authors.affiliation: 1Division of Pediatric Gastroenterology Unit 2Division of Pediatric Emergency Medicine, Department of Pediatrics 3Division of Clinical Pharmacology and Toxicology, Dana-Dwek Children's Hospital, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel 4Division of Pediatric Emergency Medicine, Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada 5Division of Clinical Pharmacology and Toxicology, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada 6Department of Anesthesiology, Tel Aviv Sourasky Medical Center, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Shlomi
authors.initials: S
authors.lastname: Cohen
authors.forename: Miguel M
authors.initials: MM
authors.lastname: Glatstein
authors.forename: Dennis
authors.initials: D
authors.lastname: Scolnik
authors.forename: Liat
authors.initials: L
authors.lastname: Rom
authors.forename: Ayala
authors.initials: A
authors.lastname: Yaron
authors.forename: Sorina
authors.initials: S
authors.lastname: Otremski
authors.forename: Amir
authors.initials: A
authors.lastname: Ben-Tov
authors.forename: Shimon
authors.initials: S
authors.lastname: Reif
mesh_terms: D000759:Adjuvants, Anesthesia / Q000008:administration & dosage; D001706:Biopsy / Q000379:methods; D002648:Child; D015331:Cohort Studies; D003113:Colonoscopy / Q000379:methods*; D005260:Female; D005283:Fentanyl / Q000008:administration & dosage*; D006776:Hospitals, Pediatric; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage; D007082:Ileum / Q000473:pathology; D015212:Inflammatory Bowel Diseases / Q000175:diagnosis; D008297:Male; D008874:Midazolam / Q000008:administration & dosage*; D015742:Propofol / Q000008:administration & dosage*; D012189:Retrospective Studies; D063128:Tertiary Health Care
chemical_list: D000759:Adjuvants, Anesthesia; D006993:Hypnotics and Sedatives; D008874:Midazolam; D005283:Fentanyl; D015742:Propofol