Target Controlled Infusion for non-anaesthesiologist propofol sedation during gastrointestinal endoscopy: The first double blind randomized controlled trial

Lorella Fanti, Marco Gemma, Massimo Agostoni, Gemma Rossi, Laura Ruggeri, Maria Luisa Azzolini, Emanuele Dabizzi, Luigi Beretta, Pier Alberto Testoni

Research output: Contribution to journalArticle

Abstract

Background: Target Controlled Infusion is a sophisticated tool for providing optimal sedation regimen avoiding under or oversedation in gastrointestinal endoscopy. Aims: To compare standard moderate sedation vs. non-anaesthesiologist-administered propofol sedation during gastrointestinal endoscopy. Methods: Randomized controlled trial of 70 consecutive colonoscopies and 70 consecutive esophagogastroduodenoscopies (EGD). Standard group (n= 70), received fentanyl (1. μg/kg) + midazolam (0.03-0.04. mg/kg) or midazolam only; propofol group (n= 70), received fentanyl (1. μg/kg) + propofol Target Controlled Infusion (1.2-1.6 μg/ml) or propofol Target Controlled Infusion only. Discharge time, endoscopist satisfaction and patient satisfaction were recorded in all endoscopies. Results: Colonoscopy: discharge time was significantly shorter in the propofol than the standard group (1.1. ± 0.3 vs. 5. ± 10.2. min, respectively; P= 0.03). Endoscopist satisfaction was significantly higher (98.3. ± 11.4/100 vs. 87.2. ± 12/100; P= 0.001); patient satisfaction was significantly higher (95. ± 9.3/100 vs. 85.5. ± 14.4/100; P= 0.002) in the propofol compared to the standard group.EGD: discharge time was not significantly different in the propofol and standard groups (1.1. ± 0.7 vs. 3.9. ± 9.2. min, respectively; P= 0.146). Endoscopist satisfaction was significantly higher (92.7. ± 14.3/100 vs. 82.8. ± 21.2/100; P= 0.03); patient satisfaction was significantly higher (93.8. ± 18.2/100 vs. 76.5. ± 25.2/100; P= 0.003). In the propofol group 94.3% of patients vs. 71.4% of patients in standard group asked to receive the same sedation in the future (P= 0.021). Conclusion: Target Controlled Infusion is a promising method for non-anaesthesiologist-administered propofol sedation.

Original languageEnglish
Pages (from-to)566-571
Number of pages6
JournalDigestive and Liver Disease
Volume47
Issue number7
DOIs
Publication statusPublished - Jul 1 2015

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Keywords

  • Gastrointestinal endoscopy
  • Propofol
  • Sedation
  • Target Controlled Infusion

ASJC Scopus subject areas

  • Gastroenterology
  • Hepatology

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