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Related Concept Videos

Parenteral Anesthetics: Overview01:24

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Intravenous anesthetics are drugs administered parenterally to induce anesthesia or sedation. Propofol is a widely used agent formulated as a 1% emulsion in soybean oil, glycerol, and egg phosphatide. It induces rapid anesthesia primarily due to its rapid distribution from the bloodstream to target tissues and is metabolized in the liver. However, it can cause significant pain on injection and hypertriglyceridemia. Fospropofol, a water-based prodrug of propofol, lacks these adverse effects.
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Sigmoidoscopy and laparoscopy are distinct medical procedures that enable physicians to internally inspect different parts of the GI tract. Although they serve different purposes, each is essential for diagnosing and, in some cases, treating various medical conditions.
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Anesthesia is a medical procedure that uses drugs for CNS suppression to enable painless surgeries and procedures. The selection of anesthetics is influenced by their pharmacokinetic properties, side effects, and patient characteristics. Various types of anesthesia include general, local, regional, spinal, and inhalational.
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Inhalation anesthetics are drugs that induce general anesthesia upon inhalation. They work by increasing the sensitivity of GABAA receptors or inhibiting NMDA receptors, leading to a decrease in central nervous system activity. The depth of anesthesia can be rapidly adjusted by changing the concentration of the inhaled gas. Some common examples of inhalational anesthetics include volatile liquids like isoflurane, desflurane, sevoflurane and gases like xenon and nitrous oxide. Isoflurane, a...
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Depolarizing blockers are administered through intravenous injection. Succinylcholine is the most common choice of depolarizing blockers in emergency clinical practices. Although they have a rapid onset, they readily diffuse away from the motor end plate into the extracellular fluid. They are metabolized by enzymes such as liver butyrylcholinesterase and plasma pseudocholinesterases. This produces a short duration of action, typically 5-10 minutes long, unlike nondepolarizing blockers, which...
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The colon, or large intestine, is the final segment of the digestive system. Its primary functions include absorbing water and vitamins produced by gut bacteria and transforming waste from liquid to solid to form stool. In adults, the large intestine is approximately 5 feet long and consists of four main sections:
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Safety of Propofol Used as a Rescue Agent During Colonoscopy.

Francis C Okeke1, Spencer Shaw, Kristel K Hunt

  • 1*Department of Medicine (Division of Hospital Medicine CIMS), Bayview Medical Center, Johns Hopkins University, Baltimore, MD †James J Peters Veterans Affairs Medical Center, and Bronx, NY.

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Propofol is safe for gastroenterologists to use for colonoscopies when standard sedation fails. This study found no increased adverse events in patients receiving propofol compared to standard sedation.

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Area of Science:

  • Gastroenterology
  • Anesthesiology
  • Clinical Safety

Background:

  • Many patients require deeper sedation than narcotics and benzodiazepines provide for colonoscopy.
  • Propofol use by gastroenterologists for colonoscopy is increasing but remains controversial.

Purpose of the Study:

  • To evaluate the safety of propofol for gastroenterologists in patients with inadequate response to standard sedation.
  • To compare adverse event rates between propofol and standard sedation groups during colonoscopy.

Main Methods:

  • Retrospective review of 403 colonoscopy records for patients receiving propofol due to inadequate response to standard sedation.
  • Comparison with 403 control patients who received only standard sedation.
  • Analysis of adverse events incidence in both groups.

Main Results:

  • No major adverse events occurred in either the propofol or standard sedation group.
  • Minor adverse event rates were similar between groups (0.02 for propofol vs. 0.01 for standard sedation).
  • Propofol group patients were younger, had a history of illicit drug use, and longer procedure times.

Conclusions:

  • Adjunctive propofol administered by gastroenterologists for conscious sedation is safe and not associated with increased adverse events.
  • Propofol may be beneficial for patients unresponsive to conventional sedation during colonoscopy.