Patient Satisfaction of Propofol Versus Midazolam and Fentanyl Sedation During Colonoscopy in Inflammatory Bowel Disease

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningfagfællebedømt

Background & Aims: Colonoscopy is essential for optimal management of inflammatory bowel disease. However, many patients opt out due to unpleasantness related to this procedure. We investigated if Nurse Administered Propofol Sedation (NAPS) would improve patient satisfaction and attitude towards future colonoscopies. Methods: Randomized clinical trial of deep sedation with NAPS (n = 63) versus moderate midazolam and fentanyl sedation (n = 67). To assess the primary end point of patient satisfaction at discharge, we developed a Satisfaction Questionnaire comprising 13 items each rated by a 5-point Likert scale and with higher scores reflecting more positive outcomes (13-65 points). Results: Fifty-six patients (43%) with ulcerative colitis, 48 (37%) with Crohn's disease, and 26 (20%) with high suspicion of inflammatory bowel disease were included. Most (88%) had previously had a colonoscopy and pre-procedure expectations were similar between groups. Patients receiving deep sedation had significantly higher satisfaction score (mean 60.1, SD 3.4) than those receiving moderate sedation (51.2, 8.4; P < .001). This was driven especially by less pain, more amnesia, sedation more to their liking, and better experience with the current than previous sedations. Importantly, these patients significantly more often preferred the same sedation for a future colonoscopy and were also inclined to accept more frequent colonoscopies. Assistance from another colonoscopist and disruption of the procedure due to pain occurred significantly more frequent in the moderate sedation group. There were no safety signals associated with NAPS. Conclusions: Patients with inflammatory bowel disease favor deep propofol sedation over moderate midazolam and fentanyl sedation. Availability of NAPS may facilitate patient adherence to endoscopy-based monitoring programs. Clinicaltrials.gov NCT01934088.

OriginalsprogEngelsk
TidsskriftClinical Gastroenterology and Hepatology
Vol/bind20
Udgave nummer3
Sider (fra-til)559-568.e5
Antal sider10
ISSN1542-3565
DOI
StatusUdgivet - 2022

Bibliografisk note

Funding Information:
Funding Supported by the Arvid Nilssons Foundation.

Funding Information:
Casper Steenholdt (Acquisition of data, analysis and interpretation of data, drafting of the manuscript, critical revision of the manuscript for important intellectual content), Jeppe T. Jensen (Study concept and design; acquisition of data; analysis and interpretation of data; drafting of the manuscript), J?rn Brynskov (Study concept and design analysis and interpretation of data; critical revision of the manuscript for important intellectual content; study supervision), Ann Merete M?ller (Sstudy concept and design, drafting of the manuscript; critical revision of the manuscript for important intellectual content), Anne Christine Limschou (Analysis and interpretation of data; critical revision of the manuscript for important intellectual content; technical, or material support), Lars Konge (Study concept and design; analysis and interpretation of data; drafting of the manuscript; critical revision of the manuscript for important intellectual content; statistical analysis), Peter Vilmann (Study concept and design; drafting of the manuscript; critical revision of the manuscript for important intellectual content administrative, technical, or material support study supervision) Funding Supported by the Arvid Nilssons Foundation.

Publisher Copyright:
© 2022 AGA Institute

ID: 314146069