Efficiency and patient experience with propofol vsconventional sedation： A prospective study

• 作者: Andreas Antoniou James Gregor Mohammad Al Beshir Nitin Khanna Patrick Thornley
• 来源期刊: 世界胃肠内镜杂志：英文版（电子版）
• 学科: 医学
• 关键词: Patient SATISFACTION FENTANYL COLONOSCOPY MIDAZOLAM PROPOFOL
• 年，卷（期）: 2016,（4）
• 页码范围: 232-238
• 页数: 7页
• 分类号: R

摘要

AIM To determine whether anaesthesiologistadministeredsedation with propofol （AAP） or endoscopist-administered conscious sedation （EAC） withfentanyl/midazolam shortens colonoscopy duration/totalroom time.METHODS： This is a prospective, non-randomized,comparative study that enrolled patients greater than18 years of age undergoing colonoscopy in a singleCanadian academic outpatient endoscopy unit over athree-month consecutive period. Colonoscopies in thisunit are performed both with AAP and EAC. Patientdemographics, procedure-related data and adverseevents were documented. Additionally, the level ofprocedure difficulty, and whether a staff endoscopist,trainee with assistance, or independent trainee, performedthe procedure were documented. A validatedmodified 4-question, 5-point Likert scale telephonesurvey was used to assess patient satisfaction withcolonoscopy. The telephone patient satisfaction surveywas conducted 24-72 h following the procedure.RESULTS： Two hundred and thirty patients were enrolled during the study period with 126 patients inthe AAP group and 104 patients in the EAC group.Mean procedure time was 18.3 ± 10.1 min in theAAP group and 14.7 ± 7.1 min in the EAC group （P =0.002）. Mean total room time was 36.8 ± 13.7 with AAPand 30.1 ± 11 min with EAC （p 〈 0.001）. Multivariateanalysis revealed the use of AAP （P = 0.002）, residentparticipation （p 〈 0.001）, diagnostic interventions （p= 0.033）, therapeutic interventions （p 〈 0.001）, lowerbody mass index （p = 0.008） and American Society ofAnaesthesiologist class （p = 0.016）, to be predictorsof longer total room time. Patient age and genderwere not significant predictors. After excluding cases inwhich trainees were involved, there was no significantdifference in procedure time between the two groups （p= 0.941）, however total room time was still prolongedin the AAP group （p = 0.019）. The amount of painexperienced was lower with AAP （p = 0.02）, with atrend toward overall higher patient satisfac