For gastrointestinal endoscopic procedures, propofol sedation has a similar risk of cardiopulmonary adverse events compared with traditional anesthesia, according to a study in Clinical Gastroenterology and Hepatology.
Researchers examined Medline, EMBASE and the Cochrane controlled trials registry and assessed the following cardiopulmonary adverse events: hypoxia, hypotension and arrhythmias. The procedures were divided into two groups based on the procedure length — a non-advanced endoscopic procedure group and an advanced endoscopic procedures group. Twenty-seven original studies, including 2,518 patients, qualified for the meta-analysis. Of the 2,518 patients, 1,324 received propofol and 1,194 received midazolam, meperidine, pethidine, remifentanil and/or fentanyl.
Here are four insights:
1. Compared with traditional sedative agents, the pooled odds ratio with the use of propofol for developing hypoxia for all the procedures combined was 0.82. The pooled odds ratio for developing hypotension was 0.92.
2. In the non-advanced endoscopic procedure group, those who received propofol were 39 percent less likely to develop complications than those receiving traditional anesthetic agents.
3. There was no difference in the complication rate for the advanced endoscopic procedures group.
4. A sub-group analysis did not show any difference in adverse events when propofol was administered.