Premium
Comparison of propofol monotherapy and propofol combination therapy for sedation during gastrointestinal endoscopy: A systematic review and meta‐analysis
Author(s) -
Yoon Sang Won,
Choi Geun Joo,
Lee Oh Haeng,
Yoon Il Jae,
Kang Hyun,
Baek Chong Wha,
Jung Yong Hun,
Woo Young Cheol
Publication year - 2018
Publication title -
digestive endoscopy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.5
H-Index - 56
eISSN - 1443-1661
pISSN - 0915-5635
DOI - 10.1111/den.13050
Subject(s) - medicine , propofol , sedation , randomized controlled trial , incidence (geometry) , anesthesia , meta analysis , endoscopy , adverse effect , relative risk , therapeutic endoscopy , strictly standardized mean difference , confidence interval , patient satisfaction , surgery , physics , optics
Background and Aim Previous randomized controlled trials have reported conflicting findings comparing propofol combination therapy ( PCT ) with propofol monotherapy ( PMT ) for sedation of patients undergoing gastrointestinal endoscopy. Therefore, a systematic review was carried out to compare the efficacy and safety of PCT and PMT in such patients. Methods We searched MEDLINE , EMBASE and CENTRAL databases to identify all randomized controlled trials that compared the efficacy and safety of PCT and PMT for sedation of patients undergoing gastrointestinal endoscopy. Primary endpoints were incidence of respiratory complications, hypotension and arrhythmia, dose of propofol used, and recovery time. Procedure duration and the satisfaction of patients and doctors were also evaluated. Results A total of 2250 patients from 22 studies were included in the final analysis. The combined analysis did not show any difference between PCT and PMT in the incidence of respiratory complications (risk ratio [ RR ], 0.80; 95% CI , 0.52 to 1.23; I 2 = 58.34%), hypotension ( RR , 1.06; 95% CI , 0.63 to 1.78; I 2 = 72.13%), arrhythmia ( RR ,1.40; 95% CI , 0.74 to 2.64; I 2 = 43.71%), recovery time (standardized mean difference [ SMD ], 0.16; 95% CI , −0.49 to 0.81; I 2 = 95.9%), procedure duration ( SMD , 0.04; 95% CI , −0.05 to 0.14; I 2 = 0.0%), patient satisfaction ( SMD , 0.13; 95% CI , −0.26 to 0.52; I 2 = 89.63%) or doctor satisfaction ( SMD , 0.01; 95% CI , −0.15 to 0.17; I 2 = 0.00%). However, the dose of propofol used was significantly lower in PCT than in PMT ( SMD , −1.38; 95% CI , −1.99 to −0.77; I 2 = 97.70%). Conclusion PCT showed comparable efficacy and safety to PMT with respect to respiratory complications, hypotension and arrhythmia, recovery time, procedure duration, patient satisfaction, and doctor satisfaction. However, the average dose of propofol used was higher in PMT .