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Related Concept Videos

Endoscopic Procedures II: Colonoscopy01:25

Endoscopic Procedures II: Colonoscopy

91
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:
91
Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy01:26

Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy

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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.
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
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Parenteral Anesthetics: Overview01:24

Parenteral Anesthetics: Overview

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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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Imaging Studies III: Gastrointestinal Motility Studies and Virtual Colonoscopy01:26

Imaging Studies III: Gastrointestinal Motility Studies and Virtual Colonoscopy

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This lesson explores three gastrointestinal imaging techniques: radionuclide testing, colonic transit studies, and virtual colonoscopy.
Radionuclide Testing
Radionuclide testing is a sophisticated medical technique for assessing gastrointestinal motility. It focuses on gastric emptying and colonic transit time. Radioactive markers track the movement of food through the digestive system, providing insights into gastrointestinal disorders.
In gastric emptying studies, a meal's liquid and...
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Stages of General Anesthesia01:22

Stages of General Anesthesia

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Various sedation levels offer significant advantages in facilitating procedural interventions for patients undergoing medical or invasive surgical procedures. These levels span from anxiolysis to general anesthesia, providing a spectrum of sedative effects to cater to specific patient needs. Anxiolysis reduces anxiety and is achieved through minimal sedation, enabling patients to remain awake and responsive while feeling more at ease during the procedure. This level can benefit minor...
427
Endoscopic Procedures I: Esophagogastroduodenoscopy01:29

Endoscopic Procedures I: Esophagogastroduodenoscopy

114
An Esophagogastroduodenoscopy (EGD) is a diagnostic procedure in which an endoscopist uses a flexible, lighted endoscope to visualize the upper gastrointestinal (GI) tract. The procedure includes visualizing the oropharynx, esophagus, stomach, and the first part of the small intestine, the duodenum.
During an EGD, the endoscope can be used to:
114
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  3. Research Domains
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  7. Oncology And Carcinogenesis
  9. Predictive And Prognostic Markers
  11. Propofol Sedation Does Not Improve Measures Of Colonoscopy Quality But Increase Cost - Findings From A Large Population-based Cohort Study.
  1. Home
  3. Research Domains
  5. Biomedical And Clinical Sciences
  7. Oncology And Carcinogenesis
  9. Predictive And Prognostic Markers
  11. Propofol Sedation Does Not Improve Measures Of Colonoscopy Quality But Increase Cost - Findings From A Large Population-based Cohort Study.

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E-Patient Counseling Trial E-PACO: Computer Based Education versus Nurse Counseling for Patients to Prepare for Colonoscopy
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Propofol sedation does not improve measures of colonoscopy quality but increase cost - findings from a large population-based cohort study.

Sheikh Rahman1,2,3, Lauren E Cipriano2,4,5,3, Cassandra McDonald2

  • 1Division of Gastroenterology, London Health Sciences Centre, Canada.

Eclinicalmedicine
|March 18, 2024

View abstract on PubMed

Summary
This summary is machine-generated.

Propofol sedation for colonoscopy did not improve quality metrics like adenoma detection rate but significantly increased costs. Routine use of propofol should be reevaluated for cost-effectiveness and quality outcomes.

Keywords:
Adenoma detection rateColonoscopyPropofolQuality assurance

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Area of Science:

  • Gastroenterology
  • Anesthesiology
  • Health Economics

Background:

  • Propofol is frequently used for sedation during colonoscopy procedures.
  • Colonoscopy quality metrics and associated costs are critical for patient care and healthcare system efficiency.

Purpose of the Study:

  • To assess the impact of propofol sedation versus conscious sedation on colonoscopy quality metrics.
  • To evaluate the cost implications of using propofol for colonoscopy.

Main Methods:

  • A population-based cohort study analyzed 46,634 colonoscopies in Ontario, Canada (April 2017-October 2018).
  • Compared propofol sedation with conscious sedation, assessing adenoma detection rate (ADR), sessile serrated polyp detection rate (ssPDR), polyp detection rate (PDR), cecal intubation rate (CIR), and perforation rate.
  • Used modified Poisson regression, adjusted for patient, procedure, and physician confounders.

    • Main Results:

    • Propofol was used in 35.2% of cases; conscious sedation in 64.8%.
    • Propofol was associated with a lower unadjusted ADR (24.6% vs. 27.0%, p < 0.0001).
    • No significant differences in ssPDR, PDR, CIR, or perforation rates were observed between groups. Multivariable analysis showed no improvement in ADR, ssPDR, PDR, or CIR with propofol.
    • Propofol sedation incurred an additional cost of $12,730,496 per 100,000 cases.

    Conclusions:

    • Propofol sedation for colonoscopy did not enhance key quality indicators.
    • The use of propofol is linked to substantially higher healthcare costs.
    • Reevaluation of the routine use of propofol for colonoscopy is warranted based on quality and cost-effectiveness.