Clinical Gastroenterology Vol.30 No.5(10)

Theme Optimal Sedation in Gastrointestinal Endoscopy : Understanding and Using the New Guidelines Correctly
Title Advantages and Disadvantages of Propofol Sedation : Komagane Propofol Sedation Method
Publish Date 2015/05
Author Akira Horiuchi Digestive Disease Center, Showa Inan General Hospital
Author Toshiyuki Makino Digestive Disease Center, Showa Inan General Hospital
Author Masashi Kajiyama Digestive Disease Center, Showa Inan General Hospital
[ Summary ] The sedation protocol for diagnostic gastrointestinal endoscopy in our hospital comprises an initial dose of propofol, based on patient age, which is injected as a bolus intravenously using the application of a butterfly needle. When the patients are under sedation, additional injections of 20‒40 mg (2‒4 ml) of propofol should be administered to obtain optimal sedation. Since the routine use of supplemental oxygen during endoscopy may mask respiratory depression, supplemental oxygen should only be administered when the SpO2 is less than 90%. When the thinner scope is used, the total dose of propofol used should be reduced, irrespective of the esophagogastroduodenoscopy and colonoscopy procedure. Full recovery is assessed using two criteria : 1) appropriate responses to questions from the recovery room nurse, and 2) the ability to walk in a straight line for 5 m. Propofol sedation using a dose of less than 200 mg may enable patients to safely drive themselves home 1 hour after endoscopy (Komagane propofol sedation method)
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