title: Propofol versus traditional sedative agents for endoscopic submucosal dissection.
abstract: OBJECTIVE
  Propofol has been suggested to be superior to benzodiazepines when used as a sedative agent for endoscopic examination. The aim of the present study was to systematically evaluate the safety and efficacy of propofol sedation for endoscopic submucosal dissection (ESD).
  
  
  METHODS
  PubMed, the Cochrane library, and the Igaku-Chuo-Zasshi database were searched in order to identify randomized trials eligible for inclusion in the systematic review. Data from the eligible studies were combined to calculate pooled odds ratios (OR) of developing restlessness, full awakening at 1 h post-ESD, hypoxia, and hypotension.
  
  
  RESULTS
  We identified three randomized trials (298 patients) from the database search. Compared with traditional sedative agents, the pooled OR of restlessness and full awakening at 1 h post-ESD with propofol sedation were 0.41 (95% confidence interval [CI]: 0.21-0.81) and 8.59 (95% CI: 4.29-17.2), respectively, without significant heterogeneity. Compared with traditional sedative agents, the pooled OR of hypoxia and hypotension with propofol sedation were 1.13 (95% CI: 0.58-2.21) and 0.92 (95% CI: 0.25-3.41), respectively, indicating no significant differences between the groups.
  
  
  CONCLUSIONS
  Propofol sedation during ESD is more effective as compared with traditional sedative agent. The risk of complications is similar.
authors.affiliation: Division of Research and Development for Minimally Invasive Treatment, Cancer Center, Keio University School of Medicine, Tokyo, Japan; Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan.
authors.forename: Toshihiro
authors.initials: T
authors.lastname: Nishizawa
authors.forename: Hidekazu
authors.initials: H
authors.lastname: Suzuki
authors.forename: Juntaro
authors.initials: J
authors.lastname: Matsuzaki
authors.forename: Takanori
authors.initials: T
authors.lastname: Kanai
authors.forename: Naohisa
authors.initials: N
authors.lastname: Yahagi
mesh_terms: D004210:Dissection; D004724:Endoscopy / Q000379:methods*; D005767:Gastrointestinal Diseases / Q000601:surgery*; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage*; D015742:Propofol / Q000008:administration & dosage*; D016032:Randomized Controlled Trials as Topic
chemical_list: D006993:Hypnotics and Sedatives; D015742:Propofol
keywords: endoscopic submucosal dissection (ESD); meta-analysis; midazolam; propofol; sedative agent