Patient-Controlled Sedation and Analgesia, Using Propofol and Alfentanil, During Colonoscopy: A Prospective Randomized Controlled Trial

Roseveare, C.; Seavell, C. R.; Patel, Payal; Criswell, J.; Kimble, J.; Jones, Carissa P; Shepherd, H. A.

doi:10.1055/s-2007-1001419

Cited by 84 publications

(63 citation statements)

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“…These include propofol administered by: (1) an anaesthesiologist [45, 54]; (2) another physician (gastroenterologist) [17, 18, 50]; (3) a trained nurse [20, 55, 47], and (4) by the patient himself [40, 56]. In a recent study, the delivery of propofol by registered nurses has been shown to be more cost-effective than administration by an anaesthesiologist or by an additional physician [18].…”

Section: Advantages and Potential Risks Of The Drugmentioning

confidence: 99%

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The Dawning of a New Sedative: Propofol in Gastrointestinal Endoscopy

Heuss

Inauen²

2004

Digestion

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Background: Using gentler endoscopes and improved sedation, great strides have been made in enhancing patients’ comfort and acceptance of endoscopic procedures. Because morbidity and mortality have been associated with benzodiazepines in endoscopic sedation, safer alternatives were sought. Propofol (2,6-diisopropylphenol), a rapid and short-acting anesthetic, initially used in the 1980’s for general anesthesia induction and maintenance, is a promising candidate. Methods: This review article examines experiences and literature references of propofol’s use in endoscopic procedures. Three critical questions are posed: What are the major advantages and potential risks of propofol? When should propofol be used? Who should administer propofol, how should it be administered, and what type of monitoring is required? Results: With considerable inter-patient variability, the propofol dose must be carefully titrated according to the individual patient’s response. Factors influencing dosage include age, ASA class, patient’s height and procedure duration. Propofol’s primary risk is its narrow therapeutic range which necessitates careful patient monitoring. Conclusions: Propofol’s advantages over benzodiazepines and narcotics include a more rapid onset of action, full relief of discomfort and rapid recovery to alertness without residual sedative effects or anterograde amnesia, thereby making this drug a cost-effective and, with proper monitoring, safe choice.

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Section: Advantages and Potential Risks Of The Drugmentioning

confidence: 99%

“…The combination of propofol with an anesthetic agent has likewise been repeatedly shown as practical for PCS [40, 54, 56, 60, 61]. The typical self-administered bolus consists of 4.8 mg propofol and 125 µg alfentanil [40, 56].…”

Section: Advantages and Potential Risks Of The Drugmentioning

confidence: 99%

The Dawning of a New Sedative: Propofol in Gastrointestinal Endoscopy

Heuss

Inauen²

2004

Digestion

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“…Table 3. Pharmacological properties of sedative agents for endoscopy (Roseveare et al, 1998;Rudner et al, 2003) For this reason, the determination of any pharmacological schemes for moderate endoscopic sedation should include an observation period supervised by an anesthesiologist, followed by a supervised drug administration period in which the anesthesiologist selects and distribute that medicine (Rex, 2006).…”

Section: Sedation and Analgesia Agent Used For Endoscopymentioning

confidence: 99%

“…Thus, even a small amount of narcotic can substantially reduce the required amount of benzodiazepines (Arrowsmith et al, 1991, Bailey et al, 1990 or propofol (Clarke et al, 2001, Cohen et al, 2004, Kern et al, 2004, Roseveare et al, 1998, Rudner et al, 1998 necessary to perform the endoscopy. Similarly, benzodiazepines have a synergistic effect with narcotics (Arrowsmith et al, 1991, Bailey et al, 1990 and propofol (Clarke et al, 2001, Cohen et al, 2004Paspatis et al, 2002;Seifert et al, 2000.…”

Section: Reversal Agentsmentioning

confidence: 99%

Sedation Related to Gastrointestinal Endoscopy

Mitrut¹,

Oana²,

Liliana³

et al. 2011

Gastrointestinal Endoscopy

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“…One study using propofol/alfentanil in 16 patients undergoing colonoscopy showed a recovery time of 9 min, patient satisfaction with the degree of sedation and comfort achieved, and no significant adverse events [13]. In a second study, the same investigators compared patient-controlled administration with conventional sedation using pethidine and a benzodiazepine in 66 patients undergoing colonoscopy.…”

Section: Patient-controlled Sedationmentioning

confidence: 99%

Computer-Assisted Propofol Administration

2010

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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.

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Patient-Controlled Sedation and Analgesia, Using Propofol and Alfentanil, During Colonoscopy: A Prospective Randomized Controlled Trial

Abstract: Patient-controlled sedation is an effective alternative to premedication with narcotic/benzodiazepine combinations during colonoscopy.

Cited by 84 publications

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The Dawning of a New Sedative: Propofol in Gastrointestinal Endoscopy

The Dawning of a New Sedative: Propofol in Gastrointestinal Endoscopy

Sedation Related to Gastrointestinal Endoscopy

Computer-Assisted Propofol Administration

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