Computer-Assisted Propofol Administration

Abstract

The use of propofol for sedation in endoscopy may allow for better quality of sedation, quicker recovery and facilitate greater throughput in endoscopy units. The cost-effectiveness and utility of propofol sedation for endoscopic procedures is contingent on the personnel and resources required to carry out the procedure. Computer-based platforms are based on the patients response to stimulation and physiologic parameters. They offer an appealing means of delivering safe and effective doses of propofol. One such means is the bispectral index where continuous EEG recordings are used to assess the degree of sedation. Another is the closed-loop target-controlled system where a set of physical parameters, such as muscle relaxation and auditory-evoked potential, determine a level of medication appropriate to achieve sedation. Patient-controlled platforms may also be used. These electronic adjuncts may help endoscopists who wish to adopt propofol sedation to change current practices with greater confidence.

Sedation in gastrointestinal endoscopy: a prospective study comparing nonanesthesiologist-administered propofol and monitored anesthesia care

“…The choice of sedative used is largely operator-dependent. A combination of benzodiazepine (mainly midazolam) and opiate (meperidine or fentanyl) is the most common approach in developed and developing countries 2 3 . During the last decade, all over the world, anesthesiologists and gastroenterologists (depending on local or national laws) have been increasingly using propofol (2,6 diisopropyl phenol) to replace classical sedation for GIE 4 5 6 7 8 .…”