Published online Jan 26, 2023. doi: 10.12998/wjcc.v11.i3.610
Peer-review started: October 12, 2022
First decision: November 11, 2022
Revised: December 19, 2022
Accepted: January 5, 2023
Article in press: January 5, 2023
Published online: January 26, 2023
Propofol, known as an effective anesthetic with rapid onset and short recovery, has been used in sedated colonoscopy. However, when used alone, high-dose propofol is usually needed for anesthesia, and this may cause anesthesia-related adverse events (AEs).
This clinical study was intended to reduce the required dose of propofol by co-administration with butorphanol in patients receiving colonoscopy under sedation.
The objective of this clinical trial was to assess the efficacy and safety of propofol target-controlled infusion (TCI) in combination with butorphanol for sedation during colonoscopy.
One hundred six patients were assigned into three groups to receive different doses of butorphanol before propofol TCI: Low-dose butorphanol group (B1), high-dose butorphanol group (B2), and control group (C). The primary outcome included the median effective concentration (EC50) of propofol TCI, and the secondary outcomes were AEs in perianesthesia and recovery characteristics.
The EC50 of propofol for TCI was 3.03 μg/mL in group B2, 3.41 μg/ in group B1, and 4.05 μg/mL in group C. The amount of propofol necessary for anesthesia was 132 mg in group B2, lower than 142 mg in group B1. Notably, the propofol TCI plus butorphanol groups (groups B1 and B2) had a lower incidence of anesthesia AEs, when compared to group C. Moreover, there were no significant differences among the three groups in the rates of AEs in perianesthesia, including hypoxemia, sinus bradycardia, hypotension, nausea and vomiting, and vertigo.
This study has shown that propofol in combination with butorphanol reduces the EC50 of propofol TCI for anesthesia in patients undergoing sedated colonoscopy, and in turn may decrease anesthesia-related AEs in patients undergoing sedated colonoscopy.
Propofol in combination with butorphanol may improve care for patients undergoing colonoscopic procedures for colorectal diseases.