226 Impact of Propofol Sedation on Colonoscopy Quality Metrics: A Population-Based Cohort Study

Abstract

INTRODUCTION: The use of propofol during colonoscopy has gained increased popularity due to deeper anesthesia compared to conscious sedation. Whether propofol sedation leads to improved colonoscopy quality metrics is unknown and the aim of our study. METHODS: We examined the association between use of propofol sedation and colonoscopy quality metrics, including adenoma detection rate (ADR), polyp detection rate (PDR), cecal intubation, and perforation, using colonoscopy quality data prospectively collected by the Southwest Regional Cancer Program, a division of Cancer Care Ontario. All colonoscopies performed for any indication across 21 hospitals in Southwest Ontario between April 2017 and December 2018 were identified. Data collected included patient and endoscopist demographics, procedural indication, bowel preparation quality, type of sedation, cecal intubation, polyp detection, and histology. Multi-variable models were built to assess the relationship between propofol sedation and adenoma detection rate (ADR), polyp detection rate (PRD), cecal intubation, and perforation risk. RESULTS: In total, 23,903 colonoscopies were identified, of which 8,533 (35.6%) procedures were performed with propofol sedation. There were no significant differences in ADR (22.6% vs. 21.6%, P = 0.156), PDR (43.9% vs. 42.6%, P = 0.05), or cecal intubation rates (97% vs 96.7%, P 0.192) between the two groups on univariate or multivariate analyses. The event rate for perforation was too low for a meaningful comparison in this analysis (1 propofol vs. 2 events for non-propofol). CONCLUSION: In this large colonoscopy cohort, propofol sedation was not associated with improved ADR, PDR, or cecal intubation rates.