Effectiveness of Endoscopist-Directed Nurse-Administered Propofol Sedation (EDNAPS) for EGD, Colonoscopy and MRCP: A Prospective Study in 929 Patients

ABSTRACT

Background/objectives: The aim of our study was to review the safety and effectiveness of Endoscopist-directed nurse-administered propofol sedation (EDNAPS) during GIT endoscopic procedures, occurrence of major and minor adverse events followed by propofol sedation, level of patient satisfaction and possible choice of propofol as sedative agent in their future endoscopic procedures in Pakistani population. Materials and methods: Prospective data were collected from patients receiving diagnostic AGD, colonoscopy or ERCP. Subjects who stopped the emergency procedure or both EGD and colonoscopy were excluded on the same date. Other exclusions include over 20 years of age, pregnancy, the American society of associate psychologists (ASA) Class III or IV, overweight (body weight>100kg), or drugs or its components or components (Soybean or egg) allergies included. Result: In our study a total of 929 patients comprising 520 males (56%) and 409 females (44%) with mean age of 46.19 ± 15.3years, mean MBI 24.27 ± 2.7. Age-specific propofol dosage was similar across gender except for age group 60 years and above where higher mean propofol dosage was required for females as compared to males for EGD and Colonoscopy (82.8 ± 32.2 vs. 63.5 ± 29.8; p-value 0.005; 81.1 ± 26.1 vs. 75.3 ± 25.0; p-value 0.03). The required examination was completed in all cases. There was no major adverse event. Majority of the patients rated the procedure satisfactory and agreed to undergo same sedative for next time. Conclusion: Endoscopist-directed nurse-administered propofol sedation (EDNAPS) during GIT endoscopic procedures is safe and effective in selected patients.