title: Target Controlled Infusion for non-anaesthesiologist propofol sedation during gastrointestinal endoscopy: The first double blind randomized controlled trial.
abstract: BACKGROUND
  Target Controlled Infusion is a sophisticated tool for providing optimal sedation regimen avoiding under or oversedation in gastrointestinal endoscopy.
  
  
  OBJECTIVE
  To compare standard moderate sedation vs. non-anaesthesiologist-administered propofol sedation during gastrointestinal endoscopy.
  
  
  METHODS
  Randomized controlled trial of 70 consecutive colonoscopies and 70 consecutive esophagogastroduodenoscopies (EGD). Standard group (n=70), received fentanyl (1 μg/kg)+midazolam (0.03-0.04 mg/kg) or midazolam only; propofol group (n=70), received fentanyl (1 μg/kg)+propofol Target Controlled Infusion (1.2-1.6 μg/ml) or propofol Target Controlled Infusion only. Discharge time, endoscopist satisfaction and patient satisfaction were recorded in all endoscopies.
  
  
  RESULTS
  Colonoscopy: discharge time was significantly shorter in the propofol than the standard group (1.1 ± 0.3 vs. 5 ± 10.2 min, respectively; P=0.03). Endoscopist satisfaction was significantly higher (98.3 ± 11.4/100 vs. 87.2±12/100; P=0.001); patient satisfaction was significantly higher (95 ± 9.3/100 vs. 85.5 ± 14.4/100; P=0.002) in the propofol compared to the standard group. EGD: discharge time was not significantly different in the propofol and standard groups (1.1 ± 0.7 vs. 3.9 ± 9.2 min, respectively; P=0.146). Endoscopist satisfaction was significantly higher (92.7 ± 14.3/100 vs. 82.8 ± 21.2/100; P=0.03); patient satisfaction was significantly higher (93.8 ± 18.2/100 vs. 76.5 ± 25.2/100; P=0.003). In the propofol group 94.3% of patients vs. 71.4% of patients in standard group asked to receive the same sedation in the future (P=0.021).
  
  
  CONCLUSIONS
  Target Controlled Infusion is a promising method for non-anaesthesiologist-administered propofol sedation.
authors.affiliation: Division of Gastroenterology and Gastrointestinal Endoscopy, Vita-Salute San Raffaele University - Scientific Institute San Raffaele, Milan, Italy. Electronic address: fanti.lorella@hsr.it.
authors.forename: Lorella
authors.initials: L
authors.lastname: Fanti
authors.affiliation: Department of Anesthesiology, Vita-Salute San Raffaele University - Scientific Institute San Raffaele, Milan, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Gemma
authors.affiliation: Department of Anesthesiology, Vita-Salute San Raffaele University - Scientific Institute San Raffaele, Milan, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Agostoni
authors.affiliation: Division of Gastroenterology and Gastrointestinal Endoscopy, Vita-Salute San Raffaele University - Scientific Institute San Raffaele, Milan, Italy.
authors.forename: Gemma
authors.initials: G
authors.lastname: Rossi
authors.affiliation: Department of Anesthesiology, Vita-Salute San Raffaele University - Scientific Institute San Raffaele, Milan, Italy.
authors.forename: Laura
authors.initials: L
authors.lastname: Ruggeri
authors.affiliation: Department of Anesthesiology, Vita-Salute San Raffaele University - Scientific Institute San Raffaele, Milan, Italy.
authors.forename: Maria Luisa
authors.initials: ML
authors.lastname: Azzolini
authors.affiliation: Division of Gastroenterology and Gastrointestinal Endoscopy, Vita-Salute San Raffaele University - Scientific Institute San Raffaele, Milan, Italy.
authors.forename: Emanuele
authors.initials: E
authors.lastname: Dabizzi
authors.affiliation: Department of Anesthesiology, Vita-Salute San Raffaele University - Scientific Institute San Raffaele, Milan, Italy.
authors.forename: Luigi
authors.initials: L
authors.lastname: Beretta
authors.affiliation: Division of Gastroenterology and Gastrointestinal Endoscopy, Vita-Salute San Raffaele University - Scientific Institute San Raffaele, Milan, Italy.
authors.forename: Pier Alberto
authors.initials: PA
authors.lastname: Testoni
mesh_terms: D000328:Adult; D000368:Aged; D016292:Procedural Sedation / Q000379:methods*; D004311:Double-Blind Method; D016099:Endoscopy, Gastrointestinal; D005260:Female; D005283:Fentanyl / Q000008:administration & dosage; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage*; D007262:Infusions, Intravenous; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008874:Midazolam / Q000008:administration & dosage; D008875:Middle Aged; D017060:Patient Satisfaction; D015742:Propofol / Q000008:administration & dosage*
chemical_list: D006993:Hypnotics and Sedatives; D008874:Midazolam; D005283:Fentanyl; D015742:Propofol
keywords: Gastrointestinal endoscopy; Propofol; Sedation; Target Controlled Infusion