Skip to main content
Top
Published in: Indian Journal of Gastroenterology 2/2018

01-03-2018 | Original Article

No increased risk of perforation during colonoscopy in patients undergoing propofol versus traditional sedation: A meta-analysis

Authors: Minmin Xue, Jian Tian, Jing Zhang, Hongbin Zhu, Jun Bai, Sujuan Zhang, Qili Wang, Shuge Wang, Xuzheng Song, Donghong Ma, Jia Li, Yongmin Zhang, Wei Li, Dongxu Wang

Published in: Indian Journal of Gastroenterology | Issue 2/2018

Login to get access

Abstract

Background and Aims

The safety of propofol sedation during colonoscopy remains unclear, and we performed a meta-analysis to assess the risk of perforation in patients undergoing propofol vs. traditional sedation.

Methods

MEDLINE, CBM, VIP, CNKI, and Wanfang databases were searched up to December 2016. Two reviewers independently assessed abstract of those searched articles. Data about perforation condition in propofol and traditional sedation groups were extracted and combined using the random effects model.

Results

A total of 19 studies were included in the current meta-analysis. Compared to traditional sedation, propofol sedation did not increase the risk of perforation (RD = − 0.00, 95% CI − 0.00~0.00, p = 0.98; subgroup analysis: OR = 1.30, 95% CI 0.83~2.05, p = 0.25).

Conclusion

This meta-analysis suggested that propofol sedation did not increase the risk of perforation compared to traditional sedation during colonoscopy.
Appendix
Available only for authorised users
Literature
1.
go back to reference Wernli KJ, Brenner AT, Rutter CM, Inadomi JM. Risks associated with anesthesia services during colonoscopy. Gastroenterology. 2016;150:888–94.CrossRefPubMed Wernli KJ, Brenner AT, Rutter CM, Inadomi JM. Risks associated with anesthesia services during colonoscopy. Gastroenterology. 2016;150:888–94.CrossRefPubMed
2.
go back to reference Rabeneck L, Paszat LF, Hilsden RJ, et al. Bleeding and perforation after outpatient colonoscopy and their risk factors in usual clinical practice. Gastroenterology. 2008;135:1899–1906, 906 e1. Rabeneck L, Paszat LF, Hilsden RJ, et al. Bleeding and perforation after outpatient colonoscopy and their risk factors in usual clinical practice. Gastroenterology. 2008;135:1899–1906, 906 e1.
3.
go back to reference Luning TH, Keemers-Gels ME, Barendregt WB, Tan AC, Rosman C. Colonoscopic perforations: a review of 30,366 patients. Surg Endosc. 2007;21:994–7.CrossRefPubMed Luning TH, Keemers-Gels ME, Barendregt WB, Tan AC, Rosman C. Colonoscopic perforations: a review of 30,366 patients. Surg Endosc. 2007;21:994–7.CrossRefPubMed
4.
go back to reference Adeyemo A, Bannazadeh M, Riggs T, Shellnut J, Barkel D, Wasvary H. Does sedation type affect colonoscopy perforation rates? Dis Colon Rectum. 2014;57:110–4.CrossRefPubMed Adeyemo A, Bannazadeh M, Riggs T, Shellnut J, Barkel D, Wasvary H. Does sedation type affect colonoscopy perforation rates? Dis Colon Rectum. 2014;57:110–4.CrossRefPubMed
5.
go back to reference Javier JP, Gabriela P, Rosario A, David C, Cristina R, Fernando B. Iatrogenic perforation in diagnostic colonoscopy related to the type of sedation. Gastrointest Endosc. 2000;51:AB68. Javier JP, Gabriela P, Rosario A, David C, Cristina R, Fernando B. Iatrogenic perforation in diagnostic colonoscopy related to the type of sedation. Gastrointest Endosc. 2000;51:AB68.
6.
go back to reference Bastaki M, Douzinas EE, Fotis TG, et al. A randomized double-blind trial of anesthesia provided for colonoscopy by university-degreed anesthesia nurses in Greece: safety and efficacy. Gastroenterol Nurs. 2013;36:223–30. Bastaki M, Douzinas EE, Fotis TG, et al. A randomized double-blind trial of anesthesia provided for colonoscopy by university-degreed anesthesia nurses in Greece: safety and efficacy. Gastroenterol Nurs. 2013;36:223–30.
7.
go back to reference Bielawska B, Day AG, Lieberman DA, Hookey LC. Risk factors for early colonoscopic perforation include non-gastroenterologist endoscopists: a multivariable analysis. Clin Gastroenterol Hepatol. 2014;12:85–92.CrossRefPubMed Bielawska B, Day AG, Lieberman DA, Hookey LC. Risk factors for early colonoscopic perforation include non-gastroenterologist endoscopists: a multivariable analysis. Clin Gastroenterol Hepatol. 2014;12:85–92.CrossRefPubMed
8.
go back to reference Goudra B, Singh PM, Gouda G, Borle A, Carlin A, Yadwad A. Propofol and non-propofol based sedation for outpatient colonoscopy-prospective comparison of depth of sedation using an EEG based SEDLine monitor. J Clin Monit Comput. 2016;30:551–7.CrossRefPubMed Goudra B, Singh PM, Gouda G, Borle A, Carlin A, Yadwad A. Propofol and non-propofol based sedation for outpatient colonoscopy-prospective comparison of depth of sedation using an EEG based SEDLine monitor. J Clin Monit Comput. 2016;30:551–7.CrossRefPubMed
9.
go back to reference Korman LY, Haddad NG, Metz DC, et al. Effect of propofol anesthesia on force application during colonoscopy. Gastrointest Endosc. 2014;79:657–62. Korman LY, Haddad NG, Metz DC, et al. Effect of propofol anesthesia on force application during colonoscopy. Gastrointest Endosc. 2014;79:657–62.
10.
go back to reference Ng JM, Kong CF, Nyam D. Patient-controlled sedation with propofol for colonoscopy. Gastrointest Endosc. 2001;54:8–13.CrossRefPubMed Ng JM, Kong CF, Nyam D. Patient-controlled sedation with propofol for colonoscopy. Gastrointest Endosc. 2001;54:8–13.CrossRefPubMed
11.
go back to reference Okholm C, Hadikhadem T, Andersen LT, Donatsky AM, Vilmann P, Achiam MP. No increased risk of perforation during colonoscopy in patients undergoing nurse administered propofol sedation. Scand J Gastroenterol. 2013;48:1333–8.CrossRefPubMed Okholm C, Hadikhadem T, Andersen LT, Donatsky AM, Vilmann P, Achiam MP. No increased risk of perforation during colonoscopy in patients undergoing nurse administered propofol sedation. Scand J Gastroenterol. 2013;48:1333–8.CrossRefPubMed
12.
go back to reference Sipe BW, Rex DK, Latinovich D, et al. Propofol versus midazolam/meperidine for outpatient colonoscopy: administration by nurses supervised by endoscopists. Gastrointest Endosc. 2002;55:815–25. Sipe BW, Rex DK, Latinovich D, et al. Propofol versus midazolam/meperidine for outpatient colonoscopy: administration by nurses supervised by endoscopists. Gastrointest Endosc. 2002;55:815–25.
13.
go back to reference Thornley P, Al Beshir M, Gregor J, Antoniou A, Khanna N. Efficiency and patient experience with propofol vs conventional sedation: a prospective study. World J Gastrointest Endosc. 2016;8:232–8.CrossRefPubMedPubMedCentral Thornley P, Al Beshir M, Gregor J, Antoniou A, Khanna N. Efficiency and patient experience with propofol vs conventional sedation: a prospective study. World J Gastrointest Endosc. 2016;8:232–8.CrossRefPubMedPubMedCentral
14.
go back to reference Ulmer BJ, Hansen JJ, Overley CA, et al. Propofol versus midazolam/fentanyl for outpatient colonoscopy: administration by nurses supervised by endoscopists. Clin Gastroenterol Hepatol. 2003;1:425–32. Ulmer BJ, Hansen JJ, Overley CA, et al. Propofol versus midazolam/fentanyl for outpatient colonoscopy: administration by nurses supervised by endoscopists. Clin Gastroenterol Hepatol. 2003;1:425–32.
15.
go back to reference Gasparovic S, Rustemovic N, Opacic M, Bates M, Petrovecki M. Comparison of colonoscopies performed under sedation with propofol or with midazolam or without sedation. Acta Med Austriaca. 2003;30:13–6.CrossRefPubMed Gasparovic S, Rustemovic N, Opacic M, Bates M, Petrovecki M. Comparison of colonoscopies performed under sedation with propofol or with midazolam or without sedation. Acta Med Austriaca. 2003;30:13–6.CrossRefPubMed
16.
go back to reference Moerman AT, Foubert LA, Herregods LL, et al. Propofol versus remifentanil for monitored anaesthesia care during colonoscopy. Eur J Anaesthesiol. 2003;20:461–6. Moerman AT, Foubert LA, Herregods LL, et al. Propofol versus remifentanil for monitored anaesthesia care during colonoscopy. Eur J Anaesthesiol. 2003;20:461–6.
17.
go back to reference Ivano FH, Romeiro PC, Matias JE, et al. Comparative study of efficacy and safety between propofol and midazolam for sedation during colonoscopy. Rev Col Bras Cir. 2010;37:10–6.CrossRefPubMed Ivano FH, Romeiro PC, Matias JE, et al. Comparative study of efficacy and safety between propofol and midazolam for sedation during colonoscopy. Rev Col Bras Cir. 2010;37:10–6.CrossRefPubMed
18.
go back to reference Cohen S, Glatstein MM, Scolnik D, et al. Propofol for pediatric colonoscopy: the experience of a large, tertiary care pediatric hospital. Am J Ther. 2014;21:509–11. Cohen S, Glatstein MM, Scolnik D, et al. Propofol for pediatric colonoscopy: the experience of a large, tertiary care pediatric hospital. Am J Ther. 2014;21:509–11.
19.
go back to reference Ja W, Pf S, Kn J, Aa H, Pw A. Propofol: multiple advantages for endoscopy and colonoscopy in 1,424 consecutive patients. Gastrointest Endosc. 2000;5:AB59. Ja W, Pf S, Kn J, Aa H, Pw A. Propofol: multiple advantages for endoscopy and colonoscopy in 1,424 consecutive patients. Gastrointest Endosc. 2000;5:AB59.
20.
go back to reference Liberati A, Altman DG, Tetzlaff J, et al. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate healthcare interventions: explanation and elaboration. BMJ. 2009;339:b2700. Liberati A, Altman DG, Tetzlaff J, et al. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate healthcare interventions: explanation and elaboration. BMJ. 2009;339:b2700.
21.
go back to reference Chen J, Xu J, Yang Y, Yi C. Efficacy of intravenous propofol sedation during routine colonoscopy in children and hypertensive patients. Chin J Dis Endosc 2001;18:346–9. Chen J, Xu J, Yang Y, Yi C. Efficacy of intravenous propofol sedation during routine colonoscopy in children and hypertensive patients. Chin J Dis Endosc 2001;18:346–9.
22.
go back to reference Li W, Zhang S, Ji M, Wu Y, Yu Z. Sedation with midazolam versus propofol in colonoscopies : A prospective randomized and controlled study. Chin J Min Inv Surg. 2007;7:180–2. Li W, Zhang S, Ji M, Wu Y, Yu Z. Sedation with midazolam versus propofol in colonoscopies : A prospective randomized and controlled study. Chin J Min Inv Surg. 2007;7:180–2.
23.
go back to reference Pan W, Bo Y, Guo Q, Chen Y, Lou X, LI Y. A comparison of Etomidate and propofol by pumbing for colonoscopy in aged patients. China Health Industry. 2014;12:17–9. Pan W, Bo Y, Guo Q, Chen Y, Lou X, LI Y. A comparison of Etomidate and propofol by pumbing for colonoscopy in aged patients. China Health Industry. 2014;12:17–9.
24.
go back to reference Syaed El Ahl MI. Modified sevoflurane-based sedation technique versus propofol sedation technique: A randomized-controlled study. Saudi J Anaesth. 2015;9:19–22. Syaed El Ahl MI. Modified sevoflurane-based sedation technique versus propofol sedation technique: A randomized-controlled study. Saudi J Anaesth. 2015;9:19–22.
25.
go back to reference Goudra B, Nuzat A, Singh PM, Borle A, Carlin A, Gouda G. Association between type of sedation and the adverse events associated with gastrointestinal endoscopy: An analysis of 5 years' data from a tertiary center in the USA. Clin Endosc. 2016;50:161–9. Goudra B, Nuzat A, Singh PM, Borle A, Carlin A, Gouda G. Association between type of sedation and the adverse events associated with gastrointestinal endoscopy: An analysis of 5 years' data from a tertiary center in the USA. Clin Endosc. 2016;50:161–9.
26.
go back to reference Schroeder C, Kaoutzanis C, Tocco-Bradley R, et al. Patients prefer propofol to midazolam plus fentanyl for sedation for colonoscopy: Results of a single-center randomized equivalence trial. Dis Colon Rectum. 2016;59:62-9. Schroeder C, Kaoutzanis C, Tocco-Bradley R, et al. Patients prefer propofol to midazolam plus fentanyl for sedation for colonoscopy: Results of a single-center randomized equivalence trial. Dis Colon Rectum. 2016;59:62-9.
27.
go back to reference Qadeer MA, Vargo JJ, Khandwala F, Lopez R, Zuccaro G. Propofol versus traditional sedative agents for gastrointestinal endoscopy: a meta-analysis. Clin Gastroenterol Hepatol. 2005;3:1049–56. Qadeer MA, Vargo JJ, Khandwala F, Lopez R, Zuccaro G. Propofol versus traditional sedative agents for gastrointestinal endoscopy: a meta-analysis. Clin Gastroenterol Hepatol. 2005;3:1049–56.
28.
go back to reference Birk J, Bath RK. Is the anesthesiologist necessary in the endoscopy suite? A review of patients, payers and safety. Expert Rev Gastroenterol Hepatol. 2015;9:883–5.CrossRefPubMed Birk J, Bath RK. Is the anesthesiologist necessary in the endoscopy suite? A review of patients, payers and safety. Expert Rev Gastroenterol Hepatol. 2015;9:883–5.CrossRefPubMed
29.
go back to reference Katherine MH, Jennifer LH, Glenn ME. More large polyps are seen on screening colonoscopy with deep sedation compared with moderate conscious sedation. Gastrointest Endosc. 2009;69:AB119–AB20. Katherine MH, Jennifer LH, Glenn ME. More large polyps are seen on screening colonoscopy with deep sedation compared with moderate conscious sedation. Gastrointest Endosc. 2009;69:AB119–AB20.
30.
go back to reference Metwally M, Agresti N, Hale WB, et al. Conscious or unconscious: the impact of sedation choice on colon adenoma detection. World J Gastroenterol. 2011;17:3912–5. Metwally M, Agresti N, Hale WB, et al. Conscious or unconscious: the impact of sedation choice on colon adenoma detection. World J Gastroenterol. 2011;17:3912–5.
31.
go back to reference Sethi S, Wadhwa V, Thaker A, et al. Propofol versus traditional sedative agents for advanced endoscopic procedures: a meta-analysis. Dig Endos. 2014;26:515–24. Sethi S, Wadhwa V, Thaker A, et al. Propofol versus traditional sedative agents for advanced endoscopic procedures: a meta-analysis. Dig Endos. 2014;26:515–24.
32.
go back to reference Bo LL, Bai Y, Bian JJ, Wen PS, Li JB, Deng XM. Propofol vs traditional sedative agents for endoscopic retrograde cholangiopancreatography: a meta-analysis. World J Gastroenterol. 2011;17:3538–43.CrossRefPubMedPubMedCentral Bo LL, Bai Y, Bian JJ, Wen PS, Li JB, Deng XM. Propofol vs traditional sedative agents for endoscopic retrograde cholangiopancreatography: a meta-analysis. World J Gastroenterol. 2011;17:3538–43.CrossRefPubMedPubMedCentral
33.
go back to reference Lee TJ, Rutter MD, Blanks RG, et al. Colonoscopy quality measures: experience from the NHS Bowel Cancer Screening Programme. Gut. 2012;61:1050–7.CrossRefPubMed Lee TJ, Rutter MD, Blanks RG, et al. Colonoscopy quality measures: experience from the NHS Bowel Cancer Screening Programme. Gut. 2012;61:1050–7.CrossRefPubMed
Metadata
Title
No increased risk of perforation during colonoscopy in patients undergoing propofol versus traditional sedation: A meta-analysis
Authors
Minmin Xue
Jian Tian
Jing Zhang
Hongbin Zhu
Jun Bai
Sujuan Zhang
Qili Wang
Shuge Wang
Xuzheng Song
Donghong Ma
Jia Li
Yongmin Zhang
Wei Li
Dongxu Wang
Publication date
01-03-2018
Publisher
Springer India
Published in
Indian Journal of Gastroenterology / Issue 2/2018
Print ISSN: 0254-8860
Electronic ISSN: 0975-0711
DOI
https://doi.org/10.1007/s12664-017-0814-9

Other articles of this Issue 2/2018

Indian Journal of Gastroenterology 2/2018 Go to the issue