A Comparison Of Three Infusion Administration Forms Of Propofol For Sedated Gastrointestinal Endoscopy

Objective(s):The sedative efficiency,safety and satisfaction of endoscopists and patients in sedated gastrointestinal endoscopy were compared among three different propofol administration methods:intermittent manual infusion(IMI),continuous infusion(CVI)and target-controlled infusion(TCI).Methods:This study was a prospective randomized controlled trial.A total of 150 patients undergoing sedated gastrointestinal endoscopy in the outpatient department of the First Affiliated Hospital of Kunming Medical University,and ASA grade was 1/Ⅱ.All patients were randomly divided into three groups,IMI group(n=50),CVI group(n=50),TCI group(n=50).The procedure time(min),recovery time(min)and propofol dosage(mg/kg)of the three groups were recorded;The occurrence of adverse events(cough,hiccups,motion,hypoxemia,hemodynamic fluctuations,arrhythmia,etc.).After the procedure,the 100 mm Visual Analogue Scale(VAS)was used to evaluate the satisfaction of endoscopists and patients by questionnaires.Results:Among the three groups,the incidence of adverse events such as hypoxemia,motion,cough and hiccup was higher in IMI group,with more fluctuation of MAP;In CVI group,the consumption of propofol was significantly more than the other two groups,the recovery time was longer;Compared with the IMI and CVI group;TCI group was associated with a lower propofol dose,a faster recovery time,and better hemodynamic and respiratory stability than the other two groups.There was almost no difference in the satisfaction of endoscopists and patients with the three methods.Conclusion(s):In deep sedation of gastrointestinal endoscopy,propofol TCI could induce faster recovery time,better hemodynamic and respiratory stability,and lower incidence of sedation-related adverse events.In addition,Sedation maintained by intermittent propofol infusion were more likely to have respiratory depression and needed additional assistance.Sedation maintained by continuous venous infusion consume more propofol and wake up longer.