Registered nurse-administered propofol sedation for upper endoscopy and colonoscopy: Why? When? How?

Douglas Rex, Christine A. Overley, John Walker

Research output: Contribution to journalArticle

62 Citations (Scopus)

Abstract

Propofol for sedation during gastrointestinal endoscopic procedures has been associated with improved patient satisfaction relative to combinations of meperidine and midazolam. Delivery of propofol by registered nurses has been shown to be more cost-effective than administration by anesthesiologists or nurse anesthetists. Here, the authors review their experience with nurse-administered propofol sedation (NAPS) at their institutions (a hospital endoscopy unit in a tertiary medical center and an ambulatory surgery center). Endoscopic procedures for which NAPS is (or is not) recommended are listed, and a profile of patients for whom NAPS is contraindicated is given. Steps toward the development of programs and acquisition of training in NAPS are recommended; these include determining what state, local, and institutional laws apply to propofol administration; developing a written protocol; and instituting a training program that proceeds from observation to supervised administration to independent administration of propofol, with appropriate monitoring of safety records. Experience with NAPS using bolus titration (dosage, timing, coadministration with other agents) is detailed, and proper patient monitoring is discussed. NAPS is in its infancy, but this method of sedation shows considerable promise for improving patient satisfaction with, and thereby the reputation of, endoscopic procedures.

Original languageEnglish
Pages (from-to)70-80
Number of pages11
JournalReviews in Gastroenterological Disorders
Volume3
Issue number2
StatePublished - Mar 2003

Fingerprint

Propofol
Colonoscopy
Endoscopy
Nurses
Patient Satisfaction
Nurse Anesthetists
Meperidine
Hospital Units
Program Development
Midazolam
Physiologic Monitoring
Ambulatory Surgical Procedures
Observation
Safety
Education
Costs and Cost Analysis

Keywords

  • Anesthesia
  • Colonoscopy
  • Endoscopy, upper
  • Propofol
  • Safety
  • Training

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Registered nurse-administered propofol sedation for upper endoscopy and colonoscopy : Why? When? How? / Rex, Douglas; Overley, Christine A.; Walker, John.

In: Reviews in Gastroenterological Disorders, Vol. 3, No. 2, 03.2003, p. 70-80.

Research output: Contribution to journalArticle

Rex, Douglas ; Overley, Christine A. ; Walker, John. / Registered nurse-administered propofol sedation for upper endoscopy and colonoscopy : Why? When? How?. In: Reviews in Gastroenterological Disorders. 2003 ; Vol. 3, No. 2. pp. 70-80.
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