title: Propofol versus traditional sedative methods for colonoscopy in a low-resource setting.
abstract: OBJECTIVE
  We set out to determine the safety and efficacy of the use of three sedative regimens, namely propofol alone, propofol with benzodiazepine and/or opioids and benzodiazepine with opioids in Nigerian patients undergoing diagnostic colonoscopy at a Nigerian tertiary hospital.
  
  
  METHODS
  A total of 120 patients undergoing outpatient colonoscopy were assigned prospectively to one of the three treatment regimens. Patients in Group A (n = 40) received propofol alone (PRO), Group B (n = 40) received propofol with midazolam and/or fentanyl and Group C (n = 40) received opioids and midazolam (fentanyl and midazolam - conscious sedation). Study outcome measures include the level of sedation, length of the procedure, sedation/recovery time, patient satisfaction and adverse events.
  
  
  RESULTS
  Patients receiving PRO alone received higher doses of PRO compared with PRO and additives (P = 0.043). The overall procedure and sedation duration were similar in both PRO containing groups but statistically significantly shorter than the conscious sedation group (P < 0.0001, P < 0.006). The recovery time was statistically shorter in the PRO additives group compared to the other two groups (P < 0.0001). While the drop in blood pressure was similar in all the groups (P = 0.227), the occurrence of hypoxaemia was higher in the PRO containing groups (P < 0.0001). Overall physicians and patients pain assessment scores were statistically different in the three groups (both P < 0.0001).
  
  
  CONCLUSIONS
  Our data suggest that PRO sedation is safe when used for outpatient diagnostic colonoscopy in low-resource settings with better patients and physician satisfaction. The synergistic sedative effect of midazolam and/or opioids combined with PRO help reducing the dose of PRO used with better recovery.
authors.affiliation: From the Department of Surgery, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Osun State, Nigeria.
authors.forename: Olusegun Isaac
authors.initials: OI
authors.lastname: Alatise
authors.forename: Afolabi M
authors.initials: AM
authors.lastname: Owojuyigbe
authors.forename: Momohsani A
authors.initials: MA
authors.lastname: Yakubu
authors.forename: Augustine E
authors.initials: AE
authors.lastname: Agbakwuru
authors.forename: Aramide F
authors.initials: AF
authors.lastname: Faponle