Effect of Aminophylline on Incidence of Apnea and Recovery Time during ‎Propofol Sedation for ‎Gastrointestinal Endoscopy

Abstract

Background: Apnea may occur during propofol sedation for endoscopy, which can be harmful to the patient and disruptive to the procedure. Objective: To test the hypothesis that a small dose of aminophylline before propofol sedation may result in a lower incidence of apnea, as well as faster emergence from sedation. Patients and Methods: The researchers conducted a single-center, prospective randomized controlled study on 76 adult ASA I or II patients with age ranged from 20 to 65 years old. They were admitted for upper gastrointestinal or colonoscopic endoscopies. All patients were sedated with 25µg fentanyl, 1mg/kg propofol bolus over 30 seconds, then propofol boluses (0.5 mg/kg) according to need. Patients were divided into two groups: Control group [Group C (n=38)], and a study group [Group Am (n=38)] who received 0.5 mg/kg aminophylline preoperatively. Apneas were counted during each procedure, and emergence from sedation was assessed with modified Aldrete score. Results: There was a statistically significant decrease in the overall incidence of apneas with aminophylline premedication (P = 0.025), as well as a reduction in the number of apneas per bolus of propofol (P = 0.006). However, there was no statistically significant difference regarding the average time to modified Aldrete score both when tested after 5 minutes or after 10 minutes after discharge from the endoscopy room. Conclusion: Premedication with a small dose of intravenous aminophylline significantly reduces the incidence of apnea during propofol sedation for gastrointestinal endoscopies, while its effect on emergence from sedation is not significant.