Safety of sodium phosphate tablets in patients receiving propofol-based sedation for colonoscopy

To compare the incidence of peri-procedure adverse events in patients undergoing colon cleansing with sodium phosphate tablets or polyethylene glycol solution prior to colonoscopy with propofol-based sedation.

Propofol is a rapidly acting hypnotic sedative general anesthetic agent increasingly being used for colonoscopy. Although traditionally patients fast overnight prior to a general anesthetic, a new Food and Drug Administration-approved sodium phosphate tablet purgative requires ingestion of 20 tablets with 56 ounces of clear liquid 3 to 5 hours prior to colonoscopy.

We retrospectively reviewed 97 outpatients who received propofol-based sedation for colonoscopy. This was a subset of a randomized, investigator-blinded, multicenter trial comparing sodium phosphate tablets with polyethylene glycol. Study data and anesthesia records were reviewed for peri-procedure hemodynamic, cardiac, and pulmonary adverse events as well as the need for hospital admission.

There were no statistically significant differences between the 2 groups when analyzed for the development of tachycardia, decrease in mean arterial pressure below 50 mmHg, or a reduction in the mean arterial pressure greater than 30% from the pre-procedure value. No patients in either group experienced hypoxia (oxygen saturation < 90%), excessive regurgitation, pneumonia, or hospital admission.

Peri-procedure adverse events occurred rarely and with no increased frequency in patients using the sodium phosphate tablet purgative and receiving propofol-based sedation. The sodium phosphate tablet purgative is safe for patients receiving propofol-based sedation for colonoscopy.