Computer-Assisted Propofol Sedation for Esophagogastroduodenoscopy Is Effective, Efficient, and Safe

Area of Science:

• Gastroenterology
• Sedation Medicine
• Medical Technology

Background:

• Computer-assisted propofol sedation (CAPS) enables non-anesthesiologists to administer propofol for gastrointestinal procedures.
• This study reports the first US medical center's 1-year experience implementing CAPS for routine esophagogastroduodenoscopy (EGD).

Purpose of the Study:

• To evaluate the safety, efficacy, and efficiency of CAPS for EGD procedures.
• To compare CAPS outcomes with historical data from midazolam and fentanyl sedation.

Main Methods:

• A retrospective analysis of 926 outpatient EGDs performed with CAPS between September 2014 and August 2015.
• Comparison of procedural success rates, procedure times, and recovery times against historical controls (September 2013 - August 2014).
• Recording and analysis of adverse events in the CAPS cohort.

Main Results:

• Procedural success rates were similar between CAPS and historical controls (99.0% vs. 99.3%).
• Procedure times were comparable (6.6 min vs. 7.4 min).
• Recovery time was significantly shorter with CAPS (31.7 min vs. 52.4 min; p < 0.001).
• Adverse events included mild oxygen desaturation (1.2%), agitation (1.6%), and one case of asymptomatic hypotension. Six patients required brief mask ventilation for desaturation.

Conclusions:

• Computer-assisted propofol sedation (CAPS) is a safe, effective, and efficient sedation method for EGD in healthy patients.
• CAPS demonstrates a significant reduction in patient recovery time compared to traditional sedation methods.