Effect and safety of propofol for sedation during colonoscopy: A meta-analysis.

STUDY OBJECTIVES

The study is to compare the efficacy and safety of propofol with traditional sedation agents for sedation during colonoscopy.

DESIGN

Meta-analysis.

SETTING

China-Japan Union Hospital of Jilin University.

MEASUREMENTS

We conducted a comprehensive literature search through the database of Pubmed, Embase, and Web of Science. The continuous outcomes were expressed with weight mean difference (WMD) or standardized mean difference (SMD) with 95% confidence interval (95%CI); and dichotomous outcomes were expressed with risk ratio (RR) with 95%CI. A fixed-effect model or random-effect model was used to pool the estimate according to the heterogeneity across included studies.

MAIN RESULTS

Nineteen studies involving 2512 patients were included in this study. Compared with traditional sedation agents, propofol had better effects in the recovery time (WMD = -5.94 min, 95%CI: -9.24, -2.63; P < 0.001), discharge time (WMD = -33.57 min, 95%CI: -71.73, -4.60; P = 0.015), satisfaction score (SMD = 0.73, 95%CI: 0.13, 1.33; P = 0.017), time to sedation (WMD = -4.31 min, 95%CI: -4.93, -3.69; P < 0.001), and time to ambulation (WMD = -27.20 min, 95%CI: -29.84, -24.56; P < 0.001). Moreover, propofol had comparable effects with traditional sedation agents in terms of other outcomes, including procedure time (WMD = -0.38 min, 95%CI: -0.84, 0.08; P = 0.108), pain score (SMD = 0.22, 95%CI: -0.21, 0.65; P = 0.318), amnesia rate (RR = 0.93, 95%CI: 0.78, 1.11; P = 0.431), apnea rate (RR = 0.52, 95%CI: 0.15, 1.85; P = 0.314), decreased heart rate (RR = 0.73, 95%CI: 0.51, 1.04; P = 0.080), decreased blood pressure (RR = 1.16, 95%CI: 0.81, 1.66; P = 0.417), and complication rate (RR = 0.62, 95%CI: 0.33, 1.15; P = 0.131).

CONCLUSION

The present study demonstrated that, propofol for sedation during colonoscopy can result in a faster recovery and discharge, a shorter time to sedation and ambulation, as well as improved patient satisfaction, but it did not increase the rate of complications. There is a need for more well-performed, large-scale trials to verify our findings.