Sedation with propofol controlled by endoscopists during percutaneous endoscopic gastrostomy

Background: propofol is a hypnotic used with increasing fre quency for sedation during endoscopic procedures. Most of the reports published related with its employment by non-anaesthesiologists, refers to basic endoscopy, with little reference to its use in advanced endoscopy. Objective: to evaluate the efficacy and safety of propofol se dation administered by endoscopists, while performing percuta neous endoscopic gastrostomy, an advanced technique that is usu ally performed in high anesthetic level risk patients. Material and methods: prospective study of a series of en doscopic gastrostomy performed consecutively in our depart ment; the sedation was carried out exclusively with propofol. The staff in the room consisted of two medical gastroenterolo gists, a nurse and a nursing assistant. Propofol was administered by bolus doses adjusted to patient weight. Arterial oxygen satu ration, heart rate and blood pressure were monitored; respirato ry activity was monitored visually by observing respiratory excur sions of the patient. Results : we included 47 patients, with an average age of 82 years. 87% were ASA III and the rest, ASA IV. The mean dose of propofol was 51 mgr. Complications were recorded: 8 cases of desaturation and two of hypotension, all of them minor and quick ly reversible. All procedures were carried out successfully, at a me dian time of 8 minutes. Conclusion: the propofol sedation carried out by non-anaes thesiologist trained staff, seems to appear as a safe and effective procedure while performing percutaneous endoscopic gastrosto my.