Propofol Sedation for Patients Undergoing Gastrointestinal Endoscopy Procedures: Challenging Existing Paradigms in Healthcare

Born an anaesthetic, propofol has in recent years re-emerged as its alter ego, a pre-eminent sedative agent. In this capacity, propofol is significantly superior to traditional sedative agents for patients undergoing gastrointestinal endoscopy procedures. A key advantage is that patients recover better after propofol sedation than conventional (benzodiazepine/opioid) sedation [1,2]. It is ironic that noteworthy research in this area has been conducted by gastroenterologists, for they are not licensed to administer propofol to patients. Propofol is considered by many to now be the preferred sedative drug for patients undergoing gastrointestinal endoscopy procedures. The worldwide demand for optimal sedation in patients undergoing endoscopy procedures is vast, and will likely multiply with increasing awareness of the advantages of propofol sedation, and a growing elderly population [3]. However, it must be born in mind that propofol was initially introduced as an anaesthetic agent, and has potent cardiorespiratory depressant properties [4]. Propofol therefore has the potential to cause apnoea, respiratory obstruction and hypotension when administered to patients as a sedative agent. Current U.S. Food and Drug Administration (FDA) regulations state that administration of propofol to patients should only be performed by trained anaesthesia personnel. This limits the availability of propofol sedation to many patients undergoing gastrointestinal endoscopic procedures.