Effect and safety of propofol for sedation during colonoscopy: A meta-analysis

Abstract

Study objectives: The study is to compare the efficacy and safety of propofol with traditional sedation agents for sedation during colonoscopy.

Design: Meta-analysis.

Setting: China-Japan Union Hospital of Jilin University.

Measurements: We conducted a comprehensive literature search through the database of Pubmed, Embase, and Web of Science. The continuous outcomes were expressed with weight mean difference (WMD) or standardized mean difference (SMD) with 95% confidence interval (95%CI); and dichotomous outcomes were expressed with risk ratio (RR) with 95%CI. A fixed-effect model or random-effect model was used to pool the estimate according to the heterogeneity across included studies.

Main results: Nineteen studies involving 2512 patients were included in this study. Compared with traditional sedation agents, propofol had better effects in the recovery time (WMD = -5.94 min, 95%CI: -9.24, -2.63; P < 0.001), discharge time (WMD = -33.57 min, 95%CI: -71.73, -4.60; P = 0.015), satisfaction score (SMD = 0.73, 95%CI: 0.13, 1.33; P = 0.017), time to sedation (WMD = -4.31 min, 95%CI: -4.93, -3.69; P < 0.001), and time to ambulation (WMD = -27.20 min, 95%CI: -29.84, -24.56; P < 0.001). Moreover, propofol had comparable effects with traditional sedation agents in terms of other outcomes, including procedure time (WMD = -0.38 min, 95%CI: -0.84, 0.08; P = 0.108), pain score (SMD = 0.22, 95%CI: -0.21, 0.65; P = 0.318), amnesia rate (RR = 0.93, 95%CI: 0.78, 1.11; P = 0.431), apnea rate (RR = 0.52, 95%CI: 0.15, 1.85; P = 0.314), decreased heart rate (RR = 0.73, 95%CI: 0.51, 1.04; P = 0.080), decreased blood pressure (RR = 1.16, 95%CI: 0.81, 1.66; P = 0.417), and complication rate (RR = 0.62, 95%CI: 0.33, 1.15; P = 0.131).

Conclusion: The present study demonstrated that, propofol for sedation during colonoscopy can result in a faster recovery and discharge, a shorter time to sedation and ambulation, as well as improved patient satisfaction, but it did not increase the rate of complications. There is a need for more well-performed, large-scale trials to verify our findings.

Keywords: Colonoscopy; Meta-analysis; Propofol; Sedation.