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Effect‐site targeted patient‐controlled sedation with propofol: comparison with anaesthetist administration for colonoscopy
Author(s) -
Stonell C. A.,
Leslie K.,
Absalom A. R.
Publication year - 2006
Publication title -
anaesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.839
H-Index - 117
eISSN - 1365-2044
pISSN - 0003-2409
DOI - 10.1111/j.1365-2044.2005.04509.x
Subject(s) - medicine , sedation , propofol , colonoscopy , anesthesia , target controlled infusion , patient satisfaction , randomized controlled trial , surgery , colorectal cancer , cancer , remifentanil
Summary Patient‐controlled sedation (PCS) allows patients to match their sedation requirement to perceived discomfort. The significant delay in onset of sedation may be overcome with effect‐site steered target controlled infusion, but previously only trials in volunteers have been carried out. We therefore conducted a randomised, double‐blind controlled trial comparing effect‐site steered propofol PCS with anaesthetist‐administered propofol sedation in 40 patients presenting for colonoscopy. The initial effect‐site target in the PCS group was 0.8 μg.ml −1 , increment was 0.1 μg.ml −1 and lockout was 3 min. Patient and endoscopist satisfaction and operating conditions were similar between the two groups. PCS patients were sedated more slowly (13 [7.1] vs. 3 [1.1] min; p < 0.0001) and less deeply (minimum BIS value: 71 [16] vs. 58 [15]; p = 0.13) than anaesthetist‐administered propofol sedation patients. More of the latter patients were hypotensive, but all patients had similar recollection of events during the procedure and similar quality of recovery.