Patients are more likely to undergo endoscopy screenings if they receive propofol sedation monitored by an anesthesiologist, as opposed to intravenous conscious sedation administered by a nurse, according to research presented by Steven M. Frank, MD, at the American Society of Anesthesiologists' annual meeting last month.
About one-half of all eligible candidates never undergo screening endoscopies because of concerns over possible pain and discomfort, according to Dr. Frank, an anesthesiologist at the Greater Baltimore (Md.) Medical Center. His research team polled 155 patients who underwent upper or lower GI endoscopy procedures at the facility in 2003 and again in 2007, surveying them on their experiences with IV midazolam and fentanyl delivered by endoscopy nurses and propofol sedation administered by anesthesiologists.
The researchers discovered a seven-to-one patient preference for propofol's deeper sedation and rapid clearance. They also determined that four times as many patients said they would be more likely to undergo endoscopy screening if they were unconscious and under the care of an anesthesiologist.
"Given that anxiety, pain, and discomfort are major deterrents to colorectal cancer screening, our findings suggest that the routine use of propofol anesthesia may improve cancer screening rates, disease detection, and reduce mortality from the second leading cause of cancer death in the United States," says Dr. Frank, adding that while most patients did not feel pain with either sedation method, they reported feeling safer under the care of an anesthesia-trained provider.
Daniel Cook |