In a prospective study of 500 patients, Ian F. Yusoff, Ginette Raymond and Anand V. Sahai have determined whether propofol for sedation in upper-GI endoscopic ultrasonography (EUS) can be administered as safely and effectively by the endoscopist performing the procedure as by a qualified person.
All patients referred for upper-GI EUS were eligible for inclusion in the study, while exclusion criteria included the following: age less than 18 years, American Society of Anesthesiology physical status class greater than 2, a potential for difficulty in airway maintenance, and allergy to propofol constituents.
The endoscopist administered propofol as an intravenous bolus followed by a constant infusion.
Adverse events, drug dosage, complications, and patient/endoscopist satisfaction were recorded.
The research group recruited a total of 500 patients (285 women, 215 men; mean age 53.4 [14.8 years]) to the study.
Mean propofol dose was 301 mg (range 100-1000 mg) and mean procedure time was 19 minutes (range 3-70 minutes). The required examination was completed in all cases and there was no major adverse event.
Oxygen desaturation (oxygen saturation < 95%) occurred in 16 (3%) patients and there were 4 (1%) cases of mild hypoxemia (saturation < 90%) but no case of severe hypoxemia (saturation <85%).
The endoscopist rated 92% of the procedures as “very smooth” or “smooth” and regarded administration of propofol as “easy” for 92%.
All patients said they would prefer the same method of sedation if the procedure were repeated.
The researchers conclude that endoscopist-administered propofol is safe and effective in selected patients.