A team from Indianapolis, Indiana, USA, evaluated the safety of propofol administered by registered nurses with gastroenterologist supervision in endoscopic procedures.
They prospectively recorded the doses of propofol and adverse reactions to the drug in 2000 patients.
In all cases, nurses who were supervised by gastroenterologists, with no involvement by an anesthesia specialist, administered propofol.
The 2000 cases included 2222 procedures.
There were 5 episodes of oxygen desaturation to < 85%.
|Oxygen desaturation related to excessive propofol administration occurred in 0.2% of procedures.|
|American Journal of Gastroenterology|
Of these, 4 seemed to be related to excessive administration of propofol and were treated by brief (< 1 min) periods of mask ventilation.
No patient required endotracheal intubation or hospital admission. Nor did any patients suffer long-term sequelae from propofol administration.
There were no perforations in 977 colonoscopies.
Douglas K. Rex, of the Indiana University Hospital, concluded on behalf of his colleagues, "Propofol can be given safely by appropriately trained nurses under supervision by endoscopists.
"Technology that allows immediate detection of apnea would likely further improve its safety."