Narcotics and benzodiazepines are commonly used for sedation during endoscopy. Propofol has certain advantages over narcotics and benzodiazepines, but its use is often controlled by anesthesia specialists.
A study published in the August issue of The American Journal of Gastroenterology investigates the safety and effectiveness of nurse-administered propofol for sedation during endoscopy.
With the assistance of an anesthesiologist, a protocol for administration of propofol by registered nurses in routine endoscopic cases was devised.
This protocol was applied in a series of 9152 endoscopies at an ambulatory surgery centre in Oregon, USA.
|84% of patients who had been sedated with narcotics and benzodiazepines during previous endoscopies preferred propofol. |
|The American Journal of Gastroenterology|
There were only seven cases of respiratory compromise all associated with upper endoscopy. Five patients required mask ventilation, but none required endotracheal intubation.
Perforation of the colon occurred in less than 1 in 1000 colonoscopies.
Patient and doctor satisfaction was high. 84% of patients who had been sedated with narcotics and benzodiazepines during previous endoscopies preferred propofol. Gastroenterologists strongly preferred propofol.
The mean time from completion of procedures to discharge in a sample of 100 patients was 18 min.
Dr John Walker, who headed the study, concludes. “Nurse-administered propofol sedation was safe and resulted in high levels of patient satisfaction and rapid postprocedure recovery and discharge”