title: SEDATION IN COLONOSCOPY BY USING THREE DIFFERENT PROPOFOL INFUSION METHODS AND ANALYSIS OF PLASMA CONCENTRATION LEVELS: A PROSPECTIVE COMPARATIVE STUDY.
abstract: The propofolemia becomes directly linked to the clinical effects of this anesthetic and is the focus for studies comparing propofol clinical use, in different administration methods routinely used in endoscopy units where sedation is widely administered to patients.
  
  
  
  To evaluate the effects of three different regimens of intravenous propofol infusion in colonoscopies.
  
  
  
  A total of 50 patients that underwent colonoscopies were consecutively assigned to three groups: 1) intermittent bolus infusion; 2) continuous manually controlled infusion; 3) continuous automatic infusion. Patients were monitored with Bispectral IndexTM (BIS) and propofol serum levels were collected at three different timepoints. The development of an original dilution of propofol and an inventive capnography catheter were necessary.
  
  
  
  Regarding clinical outcomes, statistical differences in agitation (higher in group 1, p=0.001) and initial blood pressure (p=0.008) were found. As for propofol serum levels, findings were similar in consumption per minute (p=0.748) and over time (p=0.830). In terms of cost analysis, group 1 cost was R$7.00 (approximately US$2,25); group2, R$17.50 (approximately US$5,64); and group 3, R$112.70 (approximately US$36,35, p<0.001). Capnography was able to predict 100% of the oxygen saturation drop (below 90%).
  
  
  
  The use of propofol bolus administration for colonoscopies, through continuous manually controlled infusion or automatic infusion are similar regarding propofolemia and the clinical outcomes evaluated. The use of an innovative capnography catheter is liable and low-cost solution for the early detection of airway obstruction.
authors.affiliation: Anesthesiology Division.
authors.forename: Paulo Henrique Boaventura de
authors.initials: PH
authors.lastname: Carvalho
authors.affiliation: Department of Surgery.
authors.forename: José Pinhata
authors.initials: JP
authors.lastname: Otoch
authors.affiliation: Division of Gastroenterology, University of Tennessee Health Science Center, Memphis, TN, 38163, USA.
authors.forename: Mohamad Ali
authors.initials: MA
authors.lastname: Khan
authors.affiliation: Division of Gastrointestinal Endoscopy, School of Medicine, University of São Paulo, São Paulo, SP, Brazil.
authors.forename: Paulo
authors.initials: P
authors.lastname: Sakai
authors.affiliation: Division of Gastrointestinal Endoscopy, School of Medicine, University of São Paulo, São Paulo, SP, Brazil.
authors.forename: Hugo Gonçalo
authors.initials: HG
authors.lastname: Guedes
authors.affiliation: Department of Surgery.|Division of Gastrointestinal Endoscopy, School of Medicine, University of São Paulo, São Paulo, SP, Brazil.
authors.forename: Everson Luiz de Almeida
authors.initials: EL
authors.lastname: Artifon
mesh_terms: D003113:Colonoscopy; D003365:Costs and Cost Analysis; D054810:Deep Sedation / Q000191:economics / Q000379:methods; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage* / Q000097:blood* / Q000191:economics; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D015742:Propofol / Q000008:administration & dosage* / Q000097:blood* / Q000191:economics; D011446:Prospective Studies
chemical_list: D006993:Hypnotics and Sedatives; D015742:Propofol