Around fifty years old, a colonoscopy should be done on regulare basis for colon cancer screening.
Many patients fear the procedure, but propofole sedation greatly helps to go through the exam without discomfort.
Although simple digestive endoscopies such as oesol-gastro-duodenoscopy (OGD) and colonoscopy can be performed without sedation, they are often better tolerated under sedation.
For complex procedures such as echoendoscopy and retrograde cholangiopancreatography, deep sedation is required. Since the beginnings of digestive endoscopy, benzodiazepines (alone or in association with opiates) have been administered by the endoscopy staff under the responsibility of the endoscopist. This universal practice (with the notable exception of France) is often called “traditional sedation”.
Over the past ten years, propofol has replaced benzodiazepines.
Propofol is a hypnotic agent without analgesic action with a very short half-life. Compared to benzodiazepines, the main advantage of propofol is to ensure faster induction of sedation and a shorter wake-up time. Propofol sedation can also improve patient satisfaction over traditional sedation. A little studied but important aspect is the impact of sedation on the quality of the examinations. A small-scale randomized study analyzed the quality of OGDs performed in 60 sedated patients by propofol vs. benzodiazepines. The analysis of video recordings by observers unaware of the sedation received, showed that the quality of the OGD was significantly better with the Propofol compared to benzodiazepines. Clinical practice suggests that the benefit conferred by propofol is even more important for some more complex gestures.
The cost of this technique is higher compared to traditional sedation because it requires a person dedicated exclusively to the administration of propofol.
Minimally invasive procedures such as OGD and colonoscopy can be performed under moderate sedation, with a high satisfaction rate for both the patient and the endoscopist.
Psychomotor recovery is significantly faster with propofol compared to traditional sedation.