Determination of the appropriate propofol infusion rate for outpatient upper gastrointestinal endoscopy-a randomized prospective study

Abstract

Background: Pain and discomfort related to endoscopy sessions can be alleviated by sedation, which minimizes anxiety and allows safe examination. For outpatient endoscopy, reliable short-term sedation without secondary effects is required. This study aimed to assess the effects of intravenous propofol rates on sedation in outpatients undergoing upper gastrointestinal endoscopy. Methods: This randomized prospective study evaluated 300 outpatients submitted to upper gastrointestinal endoscopy. Patients received propofol at 500, 1000 or 2000ml/h. The primary outcome assessed was hypoxemia incidence. In addition, time to sedation and incidence of hypotension, deep sedation, extremity motor activity, cough, nausea, hiccough, and awareness were evaluated. Results: Recovery time and incidence of hypoxemia, hypotension, and deep sedation were significantly increased in individuals treated at 2000ml/h in comparison with values obtained for 500 and 1000ml/h groups (P<0.01). Compared with the 500ml/h group, motor activity of the extremities, cough, nausea, hiccough, and awareness were significantly decreased and the mean scores for endoscopist's and patients' satisfaction were significantly increased in the 1000 and 2000ml/h groups (P<0.01). Conclusion: Propofol infused at 1000ml/h appeared to be the most suitable infusion rate for outpatient upper gastrointestinal endoscopy. Trial registration: Registration number: ChiCTR-TRC-14004786 ; Registration date: 2014-06-04