Euroasian journal of hepato-gastroenterology

Register      Login

VOLUME 3 , ISSUE 2 ( July-December, 2013 ) > List of Articles


Safety of Nonanesthesiologist-administered Propofol Sedation in Endoscopic Ultrasound

Muhammad Umar, Haider Ali Khan, Masood Ahmed, Hamama tul-Bushra, Gul Nisar

Citation Information : Umar M, Ali Khan H, Ahmed M, tul-Bushra H, Nisar G. Safety of Nonanesthesiologist-administered Propofol Sedation in Endoscopic Ultrasound. Euroasian J Hepatogastroenterol 2013; 3 (2):85-88.

DOI: 10.5005/jp-journals-10018-1071

License: CC BY-NC 4.0

Published Online: 01-12-2017

Copyright Statement:  Copyright © 2013; The Author(s).


Background: Sedation during complex endoscopic procedures is important for comfort and safety of patient and ensures smooth and efficient completion of the procedure. This article evaluates safety of nonanesthesiologist-administered propofol (NAAP) sedation during endoscopic ultrasound. Materials and methods: Patients undergoing endoscopic ultrasound (EUS) with propofol sedation at Center for Liver and Digestive diseases (CLD), Holy Family Hospital, Rawalpindi, Pakistan were included. The primary outcome variable was the frequency of any sedation-related complication. Results: One hundred and ten patients fulfilling the inclusion criteria were enrolled in the study. Sixty (54.5%) patients were male and 50 (45.5%) were females. The mean age of study patients was 49 ± 18 years. The mean propofol dose was 203 ± 119 mg. There were 41% (n = 45) in ASA class I, 40% (n = 44) in ASA class II and 19% (n = 21) in ASA class III. The most common endosonographic finding was mediastinal and/ or abdominal lymphadenopathy (30.9%, n = 34) followed by a pancreatic mass in 21.8% (n = 24) patients, and a space occupying lesion (SOL) in liver in 15.5% (n = 16) patients. There were three cases with gallbladder mass (2.7%), two cases with CBD mass (1.8%), three cases (2.7%) with esophageal growth and 10 (9.1%) cases with gastric masses. Most of the patients, i.e. 98.2% (n = 108) had no sedation-related complication. Only 1.8% (n = 2) patients developed sedation-related minor complications who only required bag mask ventilation and subsequently recovered without any sequel. Conclusion: NAAP for endoscopic sedation is safe in patients undergoing EUS.

PDF Share
  1. Fanti L, Agostoni M, Arcidiacono PG, Albertin A, Strini G, Carrara S, Guslandi M, Torri G, Testoni PA. Target-controlled infusion during monitored anesthesia care in patients undergoing EUS: propofol alone versus midazolam plus propofol. A prospective double-blind randomised controlled trial. Dig Liver Dis 2007 Jan;39(1): 81-86
  2. Trained registered nurses/ endoscopy teams can administer propofol safely for endoscopy. Gastroenterology 2005 Nov;129(5):1384-1391
  3. Endoscopic sedation in the United States: results from a nationwide survey. Am J Gastroenterol 2006 May;101(5):967-974
  4. Propofol use under the direction of trained gastroenterologists: an analysis of the medicolegal implications. Am J Gastroenterol 2007 Apr;102(4): 707-713
  5. Statement on safe use of propofol. Available from: publicationsAndServices/standards/37. Accessed: March 5, 2008
  6. Position statement: nonanesthesiologist administration of propofol for GI endoscopy. Gastrointest Endosc 2009 Dec;70(6):1053-1059
  7. Endoscopist-directed administration of propofol: a worldwide safety experience. Gastroenterology 2009 Oct;137(4):1229- 1237
  8. Endoscopic sedation training in gastroenterology fellowship. Gastrointest Endosc 2010 Mar;71(3):597-599
  9. Safety of propofol administered by registered nurses with gastroenterologist supervision in 2000 endoscopic cases. Am J Gastroenterol 2002 May;97(5):1159-1163
  10. Sedation with propofol plus midazolam versus propofol alone for interventional endoscopic procedures: a prospective, randomized study. Aliment Pharmacol Ther 2000 Sep;14(9): 1207-1214
  11. Position statement: Nonanesthesiologist administration of propofol for GI endoscopy. Gastroenterology 2009 Dec;137(6):2161-2167
  12. Propofol for endoscopic sedation: a protocol for safe and effective administration by the gastroenterologist. Gastrointest Endosc 2003 Nov;58(5):725-732
  13. Sedation for endoscopy: the safe use of propofol by general practitioner sedationists. Med J Aust 2002 Feb;176(4):158-161
  14. American Society for Gastrointestinal Endoscopy, Standards of Practice Committee. Guidelines for conscious sedation and monitoring during gastrointestinal endoscopy. Gastrointest Endosc 2003 Sep;58(3):317-322
  15. Balanced propofol sedation in patients undergoing EUS-FNA: a pilot study to assess feasibility and safety. Diagn Ther Endosc 2011;2011:542159
  16. Endoscopist administered propofol for upper-GI EUS is safe and effective: a prospective study in 500 patients. Gastrointest Endosc 2004 Sep;60(3):356-360
  17. Nurseadministered propofol sedation compared with midazolam and meperidine for EUS: a prospective, randomized trial. Gastrointest Endosc 2008 Sep;68(3):499-509
  18. Nurse-administered propofol sedation for upper endoscopic ultrasonography. Am J Gastroenterol 2008 Jul;103(7):1649-1656
  19. Comparison of propofol deep sedation versus moderate sedation during endosonography. Digest Dis Sci 2010 Sep;55(9):2537-2544.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.