Original ArticlesModerate level sedation during endoscopy: a prospective study using low-dose propofol, meperidine/fentanyl, and midazolam
Section snippets
Patients and methods
Consecutive patients presenting for elective outpatient colonoscopy or EGD in two private practices (L.B.C., J.A.) were invited to enroll in the study (target 100 participants). It was anticipated that this number would permit detection of deep sedation episodes occurring at a frequency of at least 5%. Patients were excluded if one of two designated independent observers (see below) was not available to record data; if the patient was unable to perform the neuropsychometric testing because of
Patient analysis and endoscopic variables
One hundred patients (mean age 57 years; range 24 to 84 years) were enrolled. The majority were in excellent health (95% ASA I or II).
The analysis of the endoscopic procedures is detailed in Table 2. Colonoscopy accounted for the majority (74%). The mean time for induction, examination, recovery, and discharge for colonoscopy was, respectively, 3 (1) minutes, 18 (6) minutes, 14 (5) minutes, and 47 (11) minutes. The comparable mean times for EGD were, respectively, 4 (2), 8 (5), 16 (5), and 42
Discussion
To determine whether propofol can be administered safely and effectively without deep sedation, the level of sedation obtained during routine endoscopy in 100 consecutive patients receiving a combination of low-dose propofol, a narcotic agent, and midazolam was assessed in the present study. An independent observer, recording depth of sedation at 2-minute intervals, rated the level as minimal in 77% of determinations and moderate in 21%. Deep sedation was recorded in only 13 instances, less
Acknowledgements
The authors are indebted to Ms. Maya Voynarovska and Ms. Jennifer Page (endoscopy assistants) for their tireless efforts during this study, and Valerie Durkalski, PhD, MPH, for her helpful suggestions and statistical support.
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