Target Controlled Infusion for non-anaesthesiologist propofol sedation during gastrointestinal endoscopy: The first double blind randomized controlled trial. Issue 7 (July 2015)

• Record Type: Journal Article
• Authors: Fanti, Lorella; Gemma, Marco; Agostoni, Massimo; Rossi, Gemma; Ruggeri, Laura; Azzolini, Maria Luisa; Dabizzi, Emanuele; Beretta, Luigi; Testoni, Pier Alberto
• Is Part Of: Digestive and liver disease. Volume 47:Issue 7(2015)
• Page Start: 566
• Page End: 571
• Publication Date: 2015-07
• Subjects: Digestive organs -- Diseases -- Periodicals; Liver -- Diseases -- Periodicals; 616.33005
• DOI: 10.1016/j.dld.2015.03.003
• Languages: English
• ISSNs: 1590-8658

Abstract

<abstract abstract-type="author" id="abs0005"> <title id="sect0005">Abstract</title> <sec> <title id="sect0010">Background</title> <p id="spar0005">Target Controlled Infusion is a sophisticated tool for providing optimal sedation regimen avoiding under or oversedation in gastrointestinal endoscopy.</p> </sec> <sec> <title id="sect0015">Aims</title> <p id="spar0010">To compare standard moderate sedation vs. non-anaesthesiologist-administered propofol sedation during gastrointestinal endoscopy.</p> </sec> <sec> <title id="sect0020">Methods</title> <p id="spar0015">Randomized controlled trial of 70 consecutive colonoscopies and 70 consecutive esophagogastroduodenoscopies (EGD). Standard group (<italic>n</italic> = 70), received fentanyl (1 μg/kg) + midazolam (0.03–0.04 mg/kg) or midazolam only; propofol group (<italic>n</italic> = 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.</p> </sec> <sec> <title id="sect0025">Results</title> <p id="spar0020">Colonoscopy: discharge time was significantly shorter in the propofol than the standard group (1.1 ± 0.3 vs. 5 ± 10.2 min, respectively; <italic>P</italic> = 0.03). Endoscopist satisfaction was significantly higher (98.3 ± 11.4/100 vs. 87.2 ± 12/100; <italic>P</italic> = 0.001); patient satisfaction was significantly higher (95 ± 9.3/100 vs. 85.5 ± 14.4/100; <italic>P</italic> = 0.002) in the propofol compared to the standard group.</p> <p id="spar0025">EGD: discharge time was not significantly different in the propofol and standard groups (1.1 ± 0.7 vs. 3.9 ± 9.2 min, respectively; <italic>P</italic> = 0.146). Endoscopist satisfaction was significantly higher (92.7 ± 14.3/100 vs. 82.8 ± 21.2/100; <italic>P</italic> = 0.03); patient satisfaction was significantly higher (93.8 ± 18.2/100 vs. 76.5 ± 25.2/100; <italic>P</italic> = 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 (<italic>P</italic> = 0.021).</p> </sec> <sec> <title id="sect0030">Conclusion</title> <p id="spar0030">Target Controlled Infusion is a promising method for non-anaesthesiologist-administered propofol sedation.</p> </sec> </abstract>