Safety and effectiveness of procedural sedation in patients with diagnostic colonoscopy: a prospective cohort study

INTRODUCTION: Experts in different countries of the world question the safety and effectiveness of the use of sedatives during colonoscopy. According to the literature, procedural sedation (PS) improves the quality of colonoscopy, provides comfort and high patient satisfaction. OBJECTIVE: To assess the safety PS of propofol during diagnostic colonoscopy and its influence on the quality criteria of the study. MATERIALS AND METHODS: We conducted a prospective, open-label cohort study at a single center, involving 200 patients from the endoscopic department between June 2020 and January 2024. Patients were divided into two groups: those undergoing colonoscopy with sedation (n = 100) and those without sedation (n = 100). To compare percentages, we utilized the Fisher’s exact test for expected counts under 10 and Pearson’s chi-squared test for counts above 10. When comparing relative indicators, an indicator of the odds ratio with a 95% confidence interval (95% CI) was used. For quantitative measures not normally distributed, the Mann—Whitney U-test was used to compare the two groups. RESULTS: The chances of developing hypoxemia in patients in the sedated group were 9.373 times higher than in the non–sedated group, the odds differences were not statistically significant (95% CI 0.498–176.426). Transient hypoxemia developed in 4 obese patients in PS conditions. The likelihood of cecal intubation was 5.3 (95% CI 1.463–18.937) times higher in the sedated group. The rate of detected colon polyps is higher in patients of the non-sedated group (p = 0.016). CONCLUSIONS: Procedural sedation of propofol is safe during diagnostic colonoscopy in patients with grade I and II on the physical status scale of the American Society of Anesthesiologists. Procedural sedation increases the rate of intubation of the caecum and does not affect the rate of detected colon polyps.