Background: The use of non-anesthesiologist-administered propofol (NAP) has grown in popularity over standard sedation and analgesia (SA) due to its superior recovery profile. Significant cardiopulmonary side effects with propofol have been reported during endoscopy. Previous trials have suggested that NAP is as safe as SA, but definitive conclusions are hampered due to small sample sizes. Purpose: To determine cardiopulmonary complications from NAP and SA utilizing a multicenter endoscopic outcomes database. Methods: GIP and SA cases from 1/16/98-6/30/03 were obtained form CORI for analysis. Clinical variables analyzed included age, gender, ASA physiologic classification, procedure type (EGD, colonoscopy, ERCP), An adjusted relative (ARR) risk was calculated for each clinical variable. Cardiopulmonary complications (CPC)include: chest pain, bradycardia, tachycardia, hypoxia, vasovagal reaction, respiratory distress, hypotension and hypertension) bleeding, perforation, and death. Results: 9,761 NAP and 528,131 SA procedures were analyzed. The overall ARR for NAP when compared to standard sedation was 1.04 (0.876 - 1.24, 95%CI). Older age and higher ASA classification were associated with an increasing risk for complications. (see table) The risk of cardiopulmonary complications for ERCP performed with NAP was 1.28 times that seen for colonoscopy. There was no gender difference. Conclusions: The overall risk of CPC for NAP and SA are equivalent. There appears to be higher CPC risk in NAP patients undergoing ERCP or with advancing age and ASA class. Future prospective studies are needed to validate this risk profile.