title: Target-Controlled Infusion of Propofol in Training Anesthesiology Residents in Colonoscopy Sedation: A Prospective Randomized Crossover Trial.
abstract: BACKGROUND
  Propofol is widely used in sedation for colonoscopy, but its adverse effects on cardiovascular and respiratory systems are still concerning. The present study investigated whether target controlled infusion (TCI) of propofol could provide a better sedation quality than manually controlled infusion (MCI) in training inexperienced anesthesiology residents.
  
  
  METHODS
  Eighteen training residents were allocated into 2 groups receiving TCI and MCI training in their first month in the endoscopy center, while receiving MCI and TCI training instead in their second month. The last 2 patients at the end of each month were included to analyze the sedation quality of TCI and MCI techniques by comparing satisfaction of endoscopist and patients based on the visual analogue scale (VAS). Heart rate (HR), mean blood pressure (MAP), SpO2, and recovery time were also compared as the secondary outcomes.
  
  
  RESULTS
  The demographic data were similarly distributed among the TCI and MCI patients. Endoscopist's satisfaction score in the TCI group was significantly higher than in the MCI group, 81.3±7.2 versus 74.2±9.5 (P=0.003), but the patients' satisfaction score was similar between the 2 groups. More stable hemodynamic status was obtained in the TCI group, manifested as higher lowest MAP and lower highest MAP than in the MCI group. Lowest SpO2 in the TCI group was significantly higher than in the MCI group. Patients in the TCI group recovered earlier than in the MCI group.
  
  
  CONCLUSIONS
  TCI is a more effective and safer technique for anesthesiology residents in sedation for colonoscopy.
authors.affiliation: Department of Anesthesiology and Intensive Care, Changhai Hospital, The Second Military Medical University, Shanghai, China (mainland).
authors.forename: Jia-feng
authors.initials: JF
authors.lastname: Wang
authors.affiliation: Department of Anesthesiology and Intensive Care, Changhai Hospital, The Second Military Medical University, Shanghai, China (mainland).
authors.forename: Bo
authors.initials: B
authors.lastname: Li
authors.affiliation: Department of Anesthesiology and Intensive Care, Changhai Hospital, The Second Military Medical University, Shanghai, China (mainland).
authors.forename: Yu-guang
authors.initials: YG
authors.lastname: Yang
authors.affiliation: Department of Anesthesiology and Intensive Care, Changhai Hospital, The Second Military Medical University, Shanghai, China (mainland).
authors.forename: Xiao-hua
authors.initials: XH
authors.lastname: Fan
authors.affiliation: Department of Anesthesiology and Intensive Care, Changhai Hospital, The Second Military Medical University, Shanghai, China (mainland).
authors.forename: Jin-bao
authors.initials: JB
authors.lastname: Li
authors.affiliation: Department of Anesthesiology and Intensive Care, Changhai Hospital, The Second Military Medical University, Shanghai, China (mainland).
authors.forename: Xiao-ming
authors.initials: XM
authors.lastname: Deng
mesh_terms: D000328:Adult; D000776:Anesthesiology / Q000193:education*; D003113:Colonoscopy / Q000193:education*; D018592:Cross-Over Studies; D003710:Demography; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D007396:Internship and Residency; D008297:Male; D015742:Propofol / Q000008:administration & dosage* / Q000494:pharmacology*; D011446:Prospective Studies
chemical_list: D015742:Propofol