Safety of propofol administered by registered nurses with gastroenterologist supervision in 2000 endoscopic cases

Abstract

Propofol can be given safely by appropriately trained nurses under supervision by endoscopists. Technology that allows immediate detection of apnea would likely further improve its safety.

Sedation for gastrointestinal endoscopy with the application of target-controlled infusion

“…In addition, undesirable cardiovascular or respiratory side effects may occur when propofol is used with opioids. Although previous studies have revealed that propofol is safe when given by registered nurses without any involvement by anesthesia specialists, several patients may require a brief period of mask ventilation for the management of prolonged apnea (10,(18)(19)(20). This side effect occurs because of the narrow therapeutic range and the lack of an antidote in cases of over-sedation and subsequent apnea.…”

Efficacy of Morning-Only Compared With Split-Dose Polyethylene Glycol Electrolyte Solution for Afternoon Colonoscopy: A Randomized Controlled Single-Blind Study

“…Large published series of patients receiving propofol-based anesthesia for endoscopy have found aspiration to be a rare event. In one, of 2,000 healthy patients undergoing endoscopic procedures with nurse-administered propofol, there were five patients whose oxygen saturation fell to below 85% (19). Several conditions may be associated with increased incidence of pulmonary aspiration during general anesthesia, including extremes of age, male gender, pregnancy, difficult airway management, and factors that decrease gastric emptying, such as concurrent opioid administration, gastrointestinal obstruction or dysfunction, obesity, or depressed level of consciousness (20,21).…”

Safety and Prevention of Complications in Endoscopic Sedation

“…Although many previous studies examined measurements of hemodynamic changes during endoscopic procedures [14,15,17,27,[31][32][33][34], few have given detailed descriptions of quantitative changes in hemodynamic parameters and oxygen saturation during endoscopic sedation. There are also no reports regarding the frequency of cough during endoscopic procedures performed under sedation.…”