Safety and efficacy of propofol alone or in combination with other agents for sedation of patients undergoing colonoscopy: an updated meta-analysis.

The aim of this meta-analysis was to assess the efficacy and safety of propofol sedation for colonoscopy in comparison with traditional sedative agents. We performed a systematic search of PubMed, Embase, Scopus, Web of Science CENTRAL (Cochrane Central Register of Controlled Trials) and Google Scholar databases to identify eligible randomized controlled trials (RCTs) published before November 2019, and compared the effect of traditional sedative agents (TA) with the effect of propofol/propofol combined with TAs for routine colonoscopy. We included 22 eligible trials in our analysis, with a total of 2575 participants. We found strong associations between propofol use and short recovery (SMD MD, -1.15 [-1.55, -0.75], p<0.00001), procedure duration (SMD -0.28 [-0.55, -0.02], p<0.05), discharge times (SMD= -0.71 [-1.06, -0.36], p<0.0001), and sedation scores (SMD 1.29 [0.36, 2.22], p<0.05). Propofol in combination with traditional agents led to a significant decrease in discharge time compared with the discharge times of traditional sedatives alone (SMD=-0.69 [-1.07, -0.31], p<0.0004). The effects of propofol on cecal intubation rates, and occurrences of hypotension and apnea were similar to those of TAs. Our results suggest that propofol can be used as a safe alternative to TAs, and can significantly shorten procedure duration, recovery and discharge times, and improve sedation depth.