Safety of Nonanesthesiologist-administered Propofol Sedation in Endoscopic Ultrasound

Abstract

Background: Sedation during complex endoscopic procedures is important for comfort and safety of patient and ensures smooth and efficient completion of the procedure. This article evaluates safety of nonanesthesiologist-administered propofol (NAAP) sedation during endoscopic ultrasound. Materials and methods: Patients undergoing endoscopic ultrasound (EUS) with propofol sedation at Center for Liver and Digestive diseases (CLD), Holy Family Hospital, Rawalpindi, Pakistan were included. The primary outcome variable was the frequency of any sedation-related complication. Results: One hundred and ten patients fulfilling the inclusion criteria were enrolled in the study. Sixty (54.5%) patients were male and 50 (45.5%) were females. The mean age of study patients was 49 ± 18 years. The mean propofol dose was 203 ± 119 mg. There were 41% (n = 45) in ASA class I, 40% (n = 44) in ASA class II and 19% (n = 21) in ASA class III. The most common endosonographic finding was mediastinal and/ or abdominal lymphadenopathy (30.9%, n = 34) followed by a pancreatic mass in 21.8% (n = 24) patients, and a space occupying lesion (SOL) in liver in 15.5% (n = 16) patients. There were three cases with gallbladder mass (2.7%), two cases with CBD mass (1.8%), three cases (2.7%) with esophageal growth and 10 (9.1%) cases with gastric masses. Most of the patients, i.e. 98.2% (n = 108) had no sedation-related complication. Only 1.8% (n = 2) patients developed sedation-related minor complications who only required bag mask ventilation and subsequently recovered without any sequel. Conclusion: NAAP for endoscopic sedation is safe in patients undergoing EUS.