HOME
Return to Table of Contents
ENDOSCOPIST ADMINISTERED PROPOFOL: A RETROSPECTIVE SAFETY STUDY
JWI Morse1, SA Fowler2, AL Morse2
1Division of Internal Medicine, Stanton Territorial Hospital, Yellowknife NT and Department of Internal Medicine, University of Alberta, Edmonton AB; 2Department of Internal Medicine, University of Saskatchewan, Saskatoon SK
Propofol is an anesthetic agent that is commonly used for conscious sedation; however, its use in the endoscopy suite has been a source of debate. A number of questions have been raised concerning potential side effects such as respiratory depression and hypotension, possible perforation due to deep sedation, and the need for concomitant monitoring by an anesthetist. Propofol has been used at the Stanton Territorial Hospital, a community hospital in Yellowknife NT, in approximately 7000 cases between 1996 and May 2007. In this setting, propofol was administered by an endoscopist or a trained endoscopy nurse under the supervision of the endoscopist. It is proposed that endoscopist administered propofol can be safely used with no additional support or monitoring without any increased risk to patients. A retrospective review of endoscopic procedures conducted at the Stanton Territorial Hospital in Yellowknife NT between 1996 and May 2007 was done. A random sample of 681 charts was selected for review of safety data and time to discharge from the endoscopy suite. The average dose of propofol was 209mg (2.74mg/kg). No patient required more than the routinely administered 2L of supplemental oxygen. The average drop in systolic blood pressure was 20.7mmHg and no patients required treatment for hypotension. No procedures were aborted for patient safety. There were no major complications including perforation or death. Average time to patient discharge was 44 minutes. In conclusion, these results show that propofol can be safely administered in a community hospital setting with no additional support or monitoring with no increased risk to patients. The short recovery time observed post-endoscopy should also be useful in promoting health care efficiency. Further study is required to assess patient satisfaction and compare recovery times between propofol and other anesthetic regimes used in endoscopy.