Propofol Versus Midazolam/Fentanyl for Outpatient Colonoscopy: Administration by Nurses Supervised by Endoscopists

Brian J. Ulmer, Jonathan J. Hansen, Christine A. Overley, Michelle R. Symms, Vidyasree Chadalawada, Suthat Liangpunsakul, Eloise Strahl, April M. Mendel, Douglas K. Rex

Research output: Contribution to journalArticle

168 Scopus citations

Abstract

Background & Aims: Propofol is under evaluation as a sedative for endoscopic procedures. We compared nurse-administered propofol to midazolam plus fentanyl for outpatient colonoscopy. Methods: One hundred outpatients undergoing colonoscopy were randomized to receive propofol or midazolam plus fentanyl, administered by a registered nurse and supervised only by an endoscopist. Endpoints were patient satisfaction, procedure and recovery times, neuropsychologic function, and complications. Results: The mean dose of propofol administered was 277 mg; mean doses of midazolam and fentanyl were 7.2 mg and 117 μg, respectively. Mean time to sedation was faster with propofol (2.1 vs. 6.1 min; P < 0.0001), and depth of sedation was greater (P < 0.0001). Patients receiving propofol reached full recovery sooner (16.5 vs. 27. 5 min; P = 0.0001) and were discharged sooner (36.5 vs. 46.1 min; P = 0.01). After recovery, the propofol group scored better on tests reflective of learning, memory, working memory span, and mental speed. Six minor complications occurred in the propofol group: 4 episodes of hypotension, 1 episode of bradycardia, and 1 rash. Five complications occurred with the use of midazolam and fentanyl: one episode of oxygen desaturation requiring mask ventilation and 4 episodes of hypotension. Patients in the propofol vs. midazolam and fentanyl groups reported similar degrees of overall satisfaction using a 10-cm visual analog scale (9.3 vs. 9.4, P > 0.5). Conclusions: Nurse-administered propofol resulted in several advantages for outpatient colonoscopy compared with midazolam plus fentanyl, but did not improve patient satisfaction.

Original languageEnglish (US)
Pages (from-to)425-432
Number of pages8
JournalClinical Gastroenterology and Hepatology
Volume1
Issue number6
DOIs
StatePublished - Nov 2003

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

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