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Safety of Non-anesthesia Provider-Administered Propofol (NAAP) Sedation in Advanced Gastrointestinal Endoscopic Procedures: Comparative Meta-Analysis of Pooled Results

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An Erratum to this article was published on 22 March 2015

Abstract

Background and Aims

The aim of the study was to evaluate the safety of non-anesthesia provider (NAAP)-administered propofol sedation for advanced endoscopic procedures with those of anesthesia provider (AAP).

Methods

PubMed, EMBASE, Cochrane Central Register of Controlled Trials, Scopus, and Web of Science databases were searched for prospective observational trials involving advanced endoscopic procedures. From a total of 519 publications, 26 were identified to meet inclusion criteria (10 AAPs and 16 NAAPs) and were analyzed. Data were analyzed for hypoxia rate, airway intervention rates, endoscopist, and patient satisfaction scores and total propofol administered.

Results

Total number of procedures in NAAP and AAP groups was 3018 and 2374, respectively. Pooled hypoxia (oxygen saturation less than 90 %) rates were 0.133 (95 % CI 0.117–0.152) and 0.143 (95 % CI 0.128–0.159) in NAAP and AAP, respectively. Similarly, pooled airway intervention rates were 0.035 (95 % CI 0.026–0.047) and 0.133 (95 % CI 0.118–0.150), respectively. Pooled patient satisfaction rate, pooled endoscopist satisfaction rate, and mean propofol administered dose for NAAP were 7.22 (95 % CI 7.17–7.27), 6.03 (95 % CI 5.94–6.11), and 251.44 mg (95 % CI 244.39–258.49) in that order compared with 9.82 (95 % CI 9.76–9.88), 9.06 (95 % CI 8.91–9.21), and 340.32 mg (95 % CI 327.30–353.33) for AAP.

Conclusions

The safety of NAAP sedation compared favorably with AAP sedation in patients undergoing advanced endoscopic procedures. However, it came at the cost of decreased patient and endoscopist satisfaction.

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Authors and Affiliations

  1. Department of Anesthesia, Hospital of the University of Pennsylvania, Philadelphia, PA, USA

    Basavana Gouda Goudra & Amulya Dravida

  2. Department of Anesthesia, All India Institute of Medical Sciences, New Delhi, India

    Preet Mohinder Singh & Anuradha Borle

  3. Drexel University, Philadelphia, PA, 19104, USA

    Gowri Gouda

  4. New York University, New York, NY, 110003, USA

    Divakara Gouda

  5. Department of Medicine, Hospital of the University of Pennsylvania, Philadelphia, PA, USA

    Vinay Chandrashakhara

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  1. Basavana Gouda Goudra
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Correspondence to Basavana Gouda Goudra.

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Goudra, B.G., Singh, P.M., Gouda, G. et al. Safety of Non-anesthesia Provider-Administered Propofol (NAAP) Sedation in Advanced Gastrointestinal Endoscopic Procedures: Comparative Meta-Analysis of Pooled Results. Dig Dis Sci 60, 2612–2627 (2015). https://doi.org/10.1007/s10620-015-3608-x

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