A Cochrane review [Abstract] 1 included 20 studies with a total of 9 166 subjects. Most studies included only healthy out-patients. One large study (n = 7 286 patients) reported only rates of colonic perforation.
Recovery time (WMD -14.2 minutes, 95% CI -17.6 to -10.8, 11 studies, 758 patients) and discharge time (WMD -20.9 minutes, 95% CI -30.9 to -10.8, 7 studies, 542 patients) were shorter with use of propofol alone or in combination with another agent compared with traditional sedatives including benzodiazepines alone or a combination of a benzodiazepine and a narcotic. There was higher patient satisfaction with use of propofol (OR for dissatisfaction 0.35, 95% CI 0.23 to 0.53). There was no difference in procedure time, cecal intubation rate or complications. There was no difference in pain control with non- patient controlled sedation (PCS) use of propofol as compared to the traditional agents (OR 0.90, 95% CI 0.58 to 1.39). Although there was higher patient satisfaction (OR for dissatisfaction 0.42, 95% CI 0.20 to 0.89), the pain control was inferior with use of PCS use of propofol as compared to the use of traditional agents (OR 3.09, 95% CI 2.15 to 4.46). There was only one study comparing administration of propofol by anesthesiologists to that by non-anesthesiologists for sedation during colonoscopy, with no difference in procedure time or patient satisfaction.
Comment: The quality of evidence is downgraded by study quality (inadequate or unclear allocation concealment and lack of blinding).
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