Endoscopy 2019; 51(04): S199
DOI: 10.1055/s-0039-1681759
ESGE Days 2019 ePosters
Friday, April 5, 2019 09:00 – 17:00: Clinical Endoscopic Practice ePosters
Georg Thieme Verlag KG Stuttgart · New York

PROPOFOL SEDATION IN COLONOSCOPY: FROM SATISFIED PATIENTS TO IMPROVED QUALITY INDICATORS

F Abu Baker
1   Hillel Yaffe Medical Center, Hadera, Israel
,
O Gal
2   Gastroenterology and Hepatology, Hillel Yaffe Medical Center, Hadera, Israel
,
A Mari
1   Hillel Yaffe Medical Center, Hadera, Israel
,
D Feldman
1   Hillel Yaffe Medical Center, Hadera, Israel
,
B Ovadia
1   Hillel Yaffe Medical Center, Hadera, Israel
,
Y Kopelman
1   Hillel Yaffe Medical Center, Hadera, Israel
› Author Affiliations
Further Information

Publication History

Publication Date:
18 March 2019 (online)

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Aims:

Propofol mediated sedation (PMS) is safe and is clearly associated with increased patient satisfaction. However, whether it results in a favourable effect on colonoscopy outcomes and performance compared to standard sedation with benzodiazepines/opiates remains unclear. This current study aims to determine the effect of PMS on colonoscopy quality measures compared to traditional sedation.

Methods:

A large cohort of 44,794 patients who underwent sedated colonoscopies over a 15- year period were included. Colonoscopy quality indicators including polyp detection rate (PDR), cecal intubation rate (CIR) as well as terminal ileum intubation rate (TIR) were examined in benzodiazepines/opiates sedated patients and compared with PMS group. Within PMS group a dose-dependent effect was assessed, and outcome of endoscopist directed PMS procedures were compared with anaesthesia provider PMS ones. Adjustment for potential confounders such as age, sex, quality of bowel preparation, procedural setting and indication was performed.

Results:

Patients who received PMS were more likely to have an enhanced PDR (22.8% vs. 20.9%; P < 0.001), as well as CIR (90.4% vs. 87.3%; P < 0.001), and TIR (6.4% vs. 1.6%; P < 0.001).. In multivariate analysis, these findings were maintained, as PMS use was significantly associated with improved PDR (OR = 1.08, 95% CI = 1.03 – 1.13; P = 0.029), CIR (OR = 1.33, 95% CI = 1.25 – 1.42; P < 0.001) and TIR (OR = 4.72, 95% CI = 4.19 – 5.31; P < 0.0001). In the PMS group, a clear dose dependent effect was demonstrated. In the same group anaesthesiology-provider administered PMS was associated with an increased PDR (26.3% vs. 22.5%; P < 0.01), but not with an improved CIR (84.1% vs. 91%; P < 0.01) or TIR (6.6% vs. 3.8%; P < 0.01).

Conclusions:

Propofol mediated sedation during colonoscopy is associated, in a dose-dependent manner, with a better examination performance and improved outcomes. Further prospective or randomised trials to support these findings are warranted.