Safety of propofol-based anesthesia for colonoscopy in older patients

We retrospectively analyzed whether sedation for colonoscopy in older patients is as safe as in younger patients. This case-control study evaluated 149 consecutive older patients aged ≥65 years and 149 younger patients aged <65 years hospitalized in a tertiary hospital gastroenterology reference center for colonoscopy with propofol sedation. Data on American Society of Anesthesiologists (ASA) class, dose of propofol, dose of intravenous fluids, blood pressure, heart rate, saturation, both before and during anesthesia were collected. Additionally, physician experience, duration of anesthesia, and recovery time were analyzed. The median age was 74,2 years in the older group and 49,4 years in the younger group. Patients were mainly ASA II in both groups. The dose of propofol administered was higher in the younger vs the older group (2,9 vs 2,01 mg/kg, p <0,0001). There were no bradyarrhythmias, no hypotension and no decrease in saturation in either group. There were no differences in blood pressure, heart rate, and saturation in older patients, regardless of whether anesthesia was performed by a resident or a specialist. In this setting, colonoscopy under propofol-based sedation in patients ≥65 years was as safe as in younger patients and there was no difference in safety when the anesthetic was administered by a resident or a specialist in anesthesiology. These data suggest that older patients do not need a longer hospital stay because of sedation.