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CC BY-NC-ND 4.0 · Endosc Int Open 2020; 08(06): E701-E707
DOI: 10.1055/a-1135-8681
Original article

Impact of propofol sedation versus opioid/benzodiazepine sedation on colonoscopy outcomes: a systematic review with meta-analysis

Muhammad Aziz
1   Department of Internal Medicine, University of Toledo Medical Center, Toledo, Ohio, United States
,
Simcha Weissman
2   Department of Medicine, Hackensack University – Palisades Medical Center, North Bergen, New Jersey, United States
,
Rawish Fatima
1   Department of Internal Medicine, University of Toledo Medical Center, Toledo, Ohio, United States
,
Zubair Khan
3   Department of Gastroenterology, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, Texas, United States
,
Babu P. Mohan
4   Department of Internal Medicine, Banner University Medical Center Tucson, Arizona, United States
,
Tej I. Mehta
5   Department of Medicine, University of South Dakota Sanford School of Medicine, Sioux Falls, South Dakota, United States
,
Wade Lee-Smith
6   University Libraries, University of Toledo, Ohio, United States
,
Ammar Hassan
7   Division of Gastroenterology, Hackensack University – Palisades Medical Center, North Bergen, New Jersey, United States
,
Michael Sciarra
7   Division of Gastroenterology, Hackensack University – Palisades Medical Center, North Bergen, New Jersey, United States
,
Ali Nawras
8   Department of Gastroenterology, University of Toledo, Toledo, Ohio, United States
,
Douglas G. Adler
9   Department of Gastroenterology, University of Utah, Salt Lake City, Utah, United States
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Abstract

Background and study aims Choice of sedation (propofol vs opioid/benzodiazepine) has been studied in the literature and has shown variable outcomes. The majority of recent studies have evaluated propofol sedation (PS) versus opioids, benzodiazepines, or a combination of both. We performed a systematic review and meta-analysis of studies comparing PS to other sedation methods to assess the impact on colonoscopy outcomes.

Methods Multiple databases were searched and studies of interest were extracted. Primary outcome of the study was adenoma detection rate (ADR) and secondary outcomes included polyp detection rate (PDR), advanced adenoma detection rate (AADR), and cecal intubation rate (CIR).

Results A total of 11 studies met the inclusion criteria with a total of 177,016 patients (148,753 and 28,263 in the opioids/benzodiazepine group and PS group, respectively). Overall, ADR (RR: 1.07, 95 % CI 0.99–1.15), PDR (RR: 1.01, 95 % CI 0.93–1.10), and AADR (RR: 1.17, 95 % CI 0.92–1.48) did not improve with the use of PS. The CIR was slightly higher for propofol sedation group (RR 1.02, 95 % CI 1.00–1.03).

Conclusion Based on our analysis, PS and opioid/benzodiazepine sedation seem to have comparable ADR. Our results do not favor use of a particular sedation method and the choice of sedation should be individualized based on patient preference, risk factors and resource availability.

Supplementary material



Publication History

Received: 29 October 2019

Accepted: 02 January 2020

Article published online:
25 May 2020

© 2020. Owner and Copyright ©

© Georg Thieme Verlag KG
Stuttgart · New York

 

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