Patient-controlled anesthesia for colonoscopy using propofol: Results of a pilot study

Background. We studied the feasibility of using patient-controlled anesthesia (PCA) for conscious sedation during colonoscopy. Methods, Patients having elective colonoscopy had medications delivered in bolus fashion by PCA pump (Abbot Lifecare Provider 5500 Infusion System). Four patients received propofol as 20 mg/dose boluses, and four patients received propofol in a 0.3 mg/kg/dose, Twelve patients received propofol at 0.2 mg/kg/dose with alfentanil at 4 mu g/kg/dose. Results, There were no clinically unacceptable changes in continuously monitored blood pressure, pulse rate, EGG, or respiratory rate. There were no adverse effects from the sedation and no complications due to colonoscopy. Recovery time was rapid, but recall persisted in most subjects. Pain and overall discomfort in patients given propofol only were rated as moderate by most subjects. Conclusion. Patient-controlled anesthesia is feasible for use in endoscopic sedation. Propofol alone did not allow adequate pain relief, but propofol and alfentanil together seemed to provide good control of pain.