title: Propofol target-controlled infusion for sedated gastrointestinal endoscopy: A comparison of propofol alone versus propofol-fentanyl-midazolam.
abstract: Gastrointestinal (GI) endoscopy is the major technique for diagnosis of GI disease and treatment. Various sedation and analgesia regimens such as midazolam, fentanyl, and propofol can be used during GI endoscopy. The purpose of the study was to compare propofol alone and propofol combination with midazolam and fentanyl in moderate sedation for GI endoscopy. One hundred patients undergoing GI endoscopy were enrolled in this study. All patients received a propofol target-controlled infusion (TCI) to maintain sedation during the procedure. Patients were randomly allocated into either Group P (propofol TCI alone) or Group C (combination of propofol TCI plus midazolam and fentanyl). Dermographic data, anesthetic parameters (sedation regimen, blood pressure, heart rate, and oxygen saturation), procedure parameters (procedure time, colonoscopy, or panendoscopy), propofol consumption, and adverse events (hypoxia, hypotension, and bradycardia) were all recorded. Postprocedural records included recovery time, postoperative adverse events (nausea, vomiting, dizziness, recall, and pain) and satisfaction. The average propofol consumption was 251 ± 83 mg in Group P and 159 ± 73 mg in Group C (p < 0.001). The incidence of transient hypotension was higher in Group P (p = 0.009). The recovery time and discharge time were both shorter in Group C (p < 0.001 and p = 0.006 respectively). Overall, postprocedural adverse events were similar in both groups. The postanesthetic satisfaction was comparable in both groups. TCI of propofol combined with midazolam and fentanyl achieved sedation with fewer hypotension episodes and shorter recovery and discharge time than propofol TCI alone in patients undergoing GI endoscopy.
authors.affiliation: Department of Anesthesiology, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung, Taiwan.
authors.forename: Chiung-Dan
authors.initials: CD
authors.lastname: Hsu
authors.affiliation: Department of Anesthesiology, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung, Taiwan.
authors.forename: Jui-Mei
authors.initials: JM
authors.lastname: Huang
authors.affiliation: Department of Anesthesiology, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung, Taiwan.
authors.forename: Ya-Ping
authors.initials: YP
authors.lastname: Chuang
authors.affiliation: Department of Anesthesiology, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung, Taiwan.
authors.forename: Hua-Yi
authors.initials: HY
authors.lastname: Wei
authors.affiliation: Department of Internal Medicine, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung, Taiwan.
authors.forename: Yu-Chung
authors.initials: YC
authors.lastname: Su
authors.affiliation: Department of Internal Medicine, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung, Taiwan.
authors.forename: Jeng-Yih
authors.initials: JY
authors.lastname: Wu
authors.affiliation: Department of Internal Medicine, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung, Taiwan.
authors.forename: Wen-Ming
authors.initials: WM
authors.lastname: Wang
authors.affiliation: Department of Anesthesiology, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung, Taiwan.
authors.forename: Hung-Te
authors.initials: HT
authors.lastname: Hsu
authors.affiliation: Department of Anesthesiology, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung, Taiwan.
authors.forename: Hui-Fang
authors.initials: HF
authors.lastname: Huang
authors.affiliation: Department of Anesthesiology, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung, Taiwan.
authors.forename: I-Cheng
authors.initials: IC
authors.lastname: Lu
authors.affiliation: Department of Anesthesiology, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung, Taiwan. Electronic address: davidlu@kmu.edu.tw.
authors.forename: David Vi
authors.initials: DV
authors.lastname: Lu
mesh_terms: D000762:Anesthesia Recovery Period; D016292:Procedural Sedation / Q000009:adverse effects; D016099:Endoscopy, Gastrointestinal / Q000009:adverse effects; D005260:Female; D005283:Fentanyl / Q000008:administration & dosage*; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D008874:Midazolam / Q000008:administration & dosage*; D008875:Middle Aged; D017060:Patient Satisfaction; D015742:Propofol / Q000008:administration & dosage*
chemical_list: D008874:Midazolam; D005283:Fentanyl; D015742:Propofol
keywords: Gastrointestinal endoscopy; Propofol; Target-controlled infusion