title: Systematic review and meta-analysis of patient-controlled sedation versus intravenous sedation for colonoscopy.
abstract: BACKGROUND
  Patient-controlled sedation (PCS) has been suggested as an alternative method for sedative colonoscopy. However, as any new techniques, PCS introduction as a potential alternative to traditional intravenous sedation (IVS) has brought about challenges. To evaluate the advantages and disadvantages between PCS and IVS more comprehensively, we conducted a systematic review and meta-analysis of the published literature.
  
  
  METHODS
  Several databases were searched from inception to 1 April, 2015, for trials comparing PCS with IVS for colonoscopy. The outcomes of interest included time for cecal intubation, rate of complete colonoscopy, dose of sedative drugs used, pain scores, recovery time, complications. Inconsistency was quantified using I (2) statistics.
  
  
  RESULTS
  In all, 12 trials were finally selected (1091 patients, with 545 in the PCS group, and 546 in the IVS group). The total propofol used, time for cecal intubation, rate of complete colonoscopy and pain score had no statistical difference between the two groups. However, PCS showed a reduction in the recovery time, incidence of oxygen desaturation and hypotension. The rates of other complications and patients' willingness to repeat the same sedation had no statistical difference between the two groups.
  
  
  CONCLUSIONS
  PCS is as feasible and effective as traditional IVS for colonoscopy, and there is a tendency that PCS shows its superiority in recovery time, incidence for oxygen saturation and hypotension.
authors.affiliation: Digestive Endoscopy Center, Department of Gastroenterology, Ruijin Hospital, School of Medicine, Shanghai Jiaotong University Shanghai 20025, People's Republic of China.
authors.forename: Yi
authors.initials: Y
authors.lastname: Lu
authors.affiliation: Department of Hepatobiliary Surgery, Chinese PLA The 455st Hospital Shanghai 200052, People's Republic of China.
authors.forename: Li-Xiao
authors.initials: LX
authors.lastname: Hao
authors.affiliation: Digestive Endoscopy Center, Department of Gastroenterology, Ruijin Hospital, School of Medicine, Shanghai Jiaotong University Shanghai 20025, People's Republic of China.
authors.forename: Lu
authors.initials: L
authors.lastname: Chen
authors.affiliation: Digestive Endoscopy Center, Department of Gastroenterology, Ruijin Hospital, School of Medicine, Shanghai Jiaotong University Shanghai 20025, People's Republic of China.
authors.forename: Zheng
authors.initials: Z
authors.lastname: Jin
authors.affiliation: Digestive Endoscopy Center, Department of Gastroenterology, Ruijin Hospital, School of Medicine, Shanghai Jiaotong University Shanghai 20025, People's Republic of China.
authors.forename: Biao
authors.initials: B
authors.lastname: Gong
keywords: Sedation; colonoscopy; intravenous sedation; meta-analysis; patient-controlled sedation