Propofol Alone Versus Propofol in Combination With Meperidine for Sedation During Colonoscopy

Abstract

For sedated colonoscopy, propofol in combination with meperidine is better than propofol alone in improving patients' tolerance and recovery.

Alternative sedation regimens for upper gastrointestinal endoscopy proven to be safe. A retrospective comparative study

“…[22] On the other hand, Lopez et al [30] found a lower rate of hypoxemia when propofol was used alone compared with propofol-meperidine during gastroscopy. Their observed incidence of hypoxemia in propofol-meperidine group (11.9%) was comparable to our findings (9.1%).…”

“…[22,23-25-28] It has been shown that the addition of ketamine to propofol allowed stable hemodynamics because of sympathomimetic effects of ketamine and reduced risk of hypoxemia even in pediatric patients with cardiac defects during procedural sedations. [8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23]24] In a prospective randomized study by Nejati et al [25] , it was reported that hypotension and hypoxemia was not observed in two of 31 patients (6.45%) and apnea was observed in one of 31 patients (3.2%) during sedation for colonoscopy with a 1:1 mixture of ketamine and propofol. Tosun et al [12] found similar rate of hypoxemia (6.52%) and no hypotension with ketamine and propofol sedation in pediatric patients who underwent UGE.…”

“…[7-18-21] Compared with propofol alone, propofol combined with an opioid or ketamine reduces propofol dose, improves dose-related cardiopulmonary complications and quality of sedation, and increases patients' tolerance during procedural sedation. [8,22] There are limited studies that have investigated the cardiopulmonary safety profile of propofol combined with the meperidine or ketamine during gastrointestinal endoscopy.…”

“…[32] Previous studies have revealed that the use of larger initial bolus doses of propofol was associated with higher incidence of hypotension. [22][23][24][25][26][27][28][29][30] Hsieh et al [21] reported hypotension incidence as 23% for an initial bolus of 1 mg/kg propofol, which was then titrated in 10-20 mg increments plus 25 mg of meperidine (dose of propofol, 129.80±37.93 mg). In contrast, Sáenz-López et al [30] reported no hypotension for an initial bolus of 20 mg of propofol, followed by boluses of 10 mg every 30 s plus 25-50 mg of meperidine (dose of propofol, 66.93 mg).…”

“…[7,18] When propofol is used alone, higher doses are often required for gastrointestinal endoscopy because of its minimal analgesic activityand thus, deepening of sedation may occur. [9,[17][18][19][20][21][22] Thus, deepening in sedation may occur related to the propofol dose. [17,18-20-22] Oversedation resulting in hypoxemia was found to be responsible for most of the cardiac arrests.…”