Digestive Disease Center, Showa Inan General Hospital, Komagane 399-4117, Japan.
World J Gastroenterol. 2012 Jul 14;18(26):3420-5. doi: 10.3748/wjg.v18.i26.3420.
To study the safety and effectiveness of propofol sedation for outpatient colonoscopy.
Propofol was given by bolus injection with an age-adjusted standard protocol consisting of 60 mg for patients < 70 years old, 40 mg for patients age 70-89 years, and 20 mg for those ≥ 90 years, and additional injections of 20 mg propofol were given up to a maximum of 200 mg. The principal parameters were the occurrence of adverse events within 24 h after colonoscopy and overall satisfaction for this procedure. Secondary parameters included successful procedure, respiratory depression, and other complications.
Consecutive patients were entered prospectively and all 2101 entered successfully completed outpatient colonoscopy. The mean dose of propofol used was 96.4 mg (range 40-200 mg). Younger patients required higher doses of propofol than older patients (20-40 years vs ≥ 61 years: 115.3 ± 32 mg vs 89.7 ± 21 mg, P < 0.001). Transient supplemental oxygen supply was needed by five patients (0.2%); no other complications occurred. The questionnaires were completed by 1820 (87%) of 2101 patients and most rated their overall satisfaction as excellent (80%) or good (17%). The majority (65%) of patients drove home or to their office after their colonoscopy. Most (99%) were willing to repeat the same procedure. No incidents occurred within 24 h after colonoscopy.
Propofol sedation using a dose < 200 mg proved both safe and practical for outpatient colonoscopy.
研究丙泊酚镇静用于门诊结肠镜检查的安全性和有效性。
采用年龄调整标准方案给予丙泊酚推注，< 70 岁患者给予 60 mg，70-89 岁患者给予 40 mg，≥ 90 岁患者给予 20 mg，最大剂量不超过 200 mg。主要参数为结肠镜检查后 24 小时内不良事件的发生情况和对该程序的总体满意度。次要参数包括手术成功、呼吸抑制和其他并发症。
连续患者前瞻性纳入，2101 例全部成功完成门诊结肠镜检查。丙泊酚的平均用量为 96.4 mg（范围 40-200 mg）。年轻患者比老年患者需要更高剂量的丙泊酚（20-40 岁 vs ≥ 61 岁：115.3 ± 32 mg vs 89.7 ± 21 mg，P < 0.001）。5 例患者（0.2%）需要短暂补充氧气。未发生其他并发症。2101 例患者中有 1820 例（87%）完成了问卷调查，大多数患者总体满意度评为优秀（80%）或良好（17%）。大多数（65%）患者在结肠镜检查后开车回家或回办公室。大多数（99%）患者愿意重复相同的程序。结肠镜检查后 24 小时内未发生任何事件。
< 200 mg 的剂量下，使用丙泊酚镇静用于门诊结肠镜检查既安全又实用。
