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Propofol, the preferred sedation for screening colonoscopy, is underused. Results of an international survey

par Riphaus, Andrea;Macias-Gomez, Carlos;Devière, Jacques ;Dumonceau, Jean-Marc
Référence Digestive and Liver Disease, 44, 5, page (389-392)
Publication Publié, 2012-05

Article révisé par les pairs

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Résumé :

Background: The use of propofol during colonoscopy has become more widespread. To increase availability while maintaining quality and decreasing costs, European Guidelines have been issued for non-anesthesiologist administration of propofol (NAAP). We aimed to assess the current use of propofol during screening colonoscopy. Methods: International survey. Results: Eighty-four questionnaires were collected from endoscopists practicing in 29 countries. Practices were most often located in high-volume community hospitals (Italy, Belgium, Spain, Netherlands in half cases). An anesthesiologist was regularly present in the Endoscopy Unit of 69.0% survey respondents. In low-risk (ASA classification, 1-2) patients, propofol, benzodiazepine. +. opioids and benzodiazepine alone were used in 45%, 31% and 14% of screening colonoscopies, respectively. Propofol was associated with the highest endoscopist satisfaction (score on a 10-point visual analogue scale, 9.2 ± 1.2 vs. 5.5 ± 1.9 and 4.7 ± 2.0 for benzodiazepine. +. opioids and benzodiazepine alone, respectively; P< 0.0001). NAAP was used by 29.9% of respondents in 9 countries and approximately two-thirds of other endoscopists would consider implementing NAAP. Main reasons for not considering NAAP implementation were medico-legal issues and cost. Conclusion: Propofol provides the highest endoscopist satisfaction but it is used in less than half of screening colonoscopies. Propofol is administered by non-anesthesiologists in one-third of settings; its implementation is foreseen by a majority of endoscopists who do not currently use it. © 2011.