Propofol has advantages as a sedative for endoscopic procedures.
Its administration by anesthesia specialists is associated with high cost.
Administration by nonanesthesiologists is controversial because of concerns about safety, particularly respiratory depression.
Dr Douglas Rex and colleagues had 3 endoscopy units develop programs to train registered nurses to administer propofol for endoscopy.
The research team estimated whether training nurses can give propofol on a widespread basis might be effective.
The team evaluated the individual safety records of all nurses and endoscopists involved in propofol delivery at the 3 centers.
The nurses were supervised only by endoscopists.
| Respiratory events requiring assisted ventilation was not different among the 3 centers|
The research team tracked the rate of adverse respiratory events from the inception of the programs.
There were a total of 36,743 cases of nurse-administered propofol sedation at the 3 centers.
The team noted no cases requiring endotracheal intubation or resulting in death, neurologic sequelae, or other permanent injury.
The rate of respiratory events requiring assisted ventilation was not significantly different among the 3 centers.
The respiratory events requiring assisted ventilation ranged from just under 1 per 500 cases to just under 1 per 1000 cases among the 3 centers.
The team found no nurse or physician for whom the rate of respiratory events requiring assisted ventilation differed from the overall rate of events.
Dr Rex's team commented, “Trained nurses and endoscopists can administer propofol safely for endoscopic procedures.”
“Nurse-administered propofol sedation is one potential solution to the high cost associated with anesthetist-delivered sedation for endoscopy.”