A Prospective Safety Study of a Low-Dose Propofol Sedation Protocol for Colonoscopy

Abstract

Propofol has been shown to be an effective method for endoscopic sedation but there are few studies of low-dose propofol protocols for gastrointestinal endoscopy. One hundred patients (American Society of Anesthesiology classes I-III) undergoing outpatient colonoscopy were enrolled prospectively in a multidrug propofol regimen that consisted of propofol, midazolam, and meperidine. Study outcome measures evaluated the level of sedation, length of procedure, sedation/recovery time, patient satisfaction, and adverse events. The mean dose of propofol was 90 +/- 40 mg. The mean times for induction of sedation, reaching the cecum, and total procedure time were 3 +/- 1 minutes, 5 +/- 3 minutes, and 17 +/- 4 minutes, respectively. Deep sedation was observed in only 0.3% of observations. Postprocedure, the mean times to stand at the bedside without assistance, completion of all discharge criteria, and actual discharge were 10 +/- 8 minutes, 20 +/- 20 minutes, and 37 +/- 23 minutes, respectively. Patient satisfaction ratings were high on a 10-point scale, with mean total procedure and sedation satisfaction scores of 9.4 +/- 0.8 and 9.4 +/- 1.1. In 99% of patients, no supplemental oxygen was required. No serious adverse events occurred. This protocol for propofol administration is safe and effective for patients undergoing elective colonoscopy. The level of sedation was titrated readily to a moderate level of sedation while preserving a high degree of patient satisfaction.