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Patient Satisfaction With Propofol for Outpatient Colonoscopy: A Prospective, Randomized, Double-Blind Study.

Anantha Padmanabhan1, Christoforos Frangopoulos, Lynn E T Shaffer

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Patients undergoing outpatient colonoscopies reported higher satisfaction with propofol anesthesia compared to fentanyl/midazolam. Propofol also led to fewer procedure difficulties and complications, indicating its superiority for this common procedure.

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Area of Science:

  • Anesthesiology
  • Gastroenterology
  • Patient Safety

Background:

  • Propofol is recognized for its anesthetic properties in outpatient settings.
  • Limited data exists on patient satisfaction with propofol for colonoscopies.

Purpose of the Study:

  • To compare patient satisfaction with propofol versus fentanyl/midazolam for outpatient colonoscopies.
  • To evaluate safety and complication rates as secondary outcomes.

Main Methods:

  • A double-blind, randomized controlled trial involving 600 patients undergoing outpatient colonoscopy.
  • Patients received either fentanyl/midazolam or propofol for sedation.
  • Patient satisfaction assessed via Likert scale; complications and post-procedure issues were recorded.

Main Results:

  • Propofol group reported significantly higher satisfaction (86.3% vs 74%) and fewer "just right" anesthesia ratings (98.7% vs 91.3%).
  • Fewer patients on propofol recalled being awake (2% vs 17%) and procedures were rated "difficult" less often (4.3% vs 26%).
  • Complication rates were substantially lower with propofol (2.7% vs 11.7%).

Conclusions:

  • Patients demonstrate a preference for propofol over fentanyl/midazolam for outpatient colonoscopies.
  • Propofol offers superior patient and provider experiences for this procedure.
  • The endoscopist's inability to be fully blinded is a limitation.