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Patient-controlled sedation with propofol for colonoscopy
1Department of Anaesthesia and Surgical Intensive Care, Singapore General Hospital, Singapore.
Gastrointestinal Endoscopy
|June 28, 2001
Summary
Patient-controlled sedation (PCS) with propofol improved patient cooperation and satisfaction during colonoscopy. This method led to earlier discharge compared to traditional sedation.
Area of Science:
- Anesthesiology
- Gastroenterology
- Pharmacology
Background:
- Patient-controlled sedation (PCS) enables patients to self-administer sedative doses.
- Traditional sedation methods rely on anesthetist administration.
Purpose of the Study:
- To compare the efficacy of propofol-based PCS versus midazolam-based anesthetist-administered sedation.
- To evaluate patient cooperation, satisfaction, and procedural outcomes during colonoscopy.
Main Methods:
- Randomized trial of 88 patients undergoing colonoscopy.
- Comparison of propofol PCS (0.3 mg/kg bolus, zero lockout) with midazolam (0.05 mg/kg bolus, 1 mg increments).
- Monitoring of hemodynamics, oxygen saturation, sedation levels, and patient/endoscopist satisfaction.
Main Results:
- Propofol PCS demonstrated superior patient cooperation and endoscopist satisfaction.
- Patients receiving propofol PCS were more alert post-procedure and discharged significantly earlier (43.3 min vs. 61.0 min).
- Higher patient satisfaction with overall comfort was reported in the propofol PCS group (86% vs. 61%).
Conclusions:
- Patient-controlled sedation with propofol is an effective sedation strategy for colonoscopy.
- Propofol PCS significantly enhances patient satisfaction and facilitates expedited recovery and discharge.