Propofol versus traditional sedative methods for colonoscopy in a low-resource setting

Area of Science:

• Anesthesiology
• Gastroenterology
• Pharmacology

Background:

• Sedation is crucial for patient comfort during diagnostic colonoscopies.
• Optimizing sedative regimens is essential, particularly in low-resource settings.

Purpose of the Study:

• To evaluate the safety and efficacy of three sedative regimens for diagnostic colonoscopy in Nigerian patients.
• To compare propofol alone, propofol with adjuncts, and conscious sedation (midazolam/opioids).

Main Methods:

• 120 outpatients undergoing colonoscopy were prospectively assigned to three groups: propofol alone (PRO), propofol with midazolam/fentanyl, or midazolam/opioids.
• Outcomes measured included sedation level, procedure/sedation duration, recovery time, patient satisfaction, and adverse events.

Main Results:

• Propofol alone required higher doses than propofol with adjuncts.
• Procedure and sedation durations were shorter with propofol-based regimens compared to conscious sedation.
• Recovery time was shortest with propofol plus adjuncts.
• Hypoxemia occurred more frequently with propofol-containing regimens, while blood pressure drops were similar across groups.
• Physician and patient pain scores differed significantly among the three groups.

Conclusions:

• Propofol sedation is safe and effective for outpatient colonoscopies in resource-limited environments.
• Adjuncts like midazolam and/or opioids enhance propofol's sedative effect, allowing lower propofol doses and improving recovery.
• These findings support optimized propofol-based sedation for improved patient and physician satisfaction.