A Prospective Safety Study of a Low-dose Propofol Sedation Protocol for Colonoscopy

Background & Aims: Propofol has been shown to be an effective method for endoscopic sedation but there are few studies of low-dose propofol protocols for gastrointestinal endoscopy.

Methods: One hundred patients (American Society of Anesthesiology classes I-III) undergoing outpatient colonoscopy were enrolled prospectively in a multidrug propofol regimen that consisted of propofol, midazolam, and meperidine. Study outcome measures evaluated the level of sedation, length of procedure, sedation/recovery time, patient satisfaction, and adverse events.

Results: The mean dose of propofol was 90 +/- 40 mg. The mean times for induction of sedation, reaching the cecum, and total procedure time were 3 +/- 1 minutes, 5 +/- 3 minutes, and 17 +/- 4 minutes, respectively. Deep sedation was observed in only 0.3% of observations. Postprocedure, the mean times to stand at the bedside without assistance, completion of all discharge criteria, and actual discharge were 10 +/- 8 minutes, 20 +/- 20 minutes, and 37 +/- 23 minutes, respectively. Patient satisfaction ratings were high on a 10-point scale, with mean total procedure and sedation satisfaction scores of 9.4 +/- 0.8 and 9.4 +/- 1.1. In 99% of patients, no supplemental oxygen was required. No serious adverse events occurred.

Conclusions: This protocol for propofol administration is safe and effective for patients undergoing elective colonoscopy. The level of sedation was titrated readily to a moderate level of sedation while preserving a high degree of patient satisfaction.