Endoscopy 2011; 43(8): 716-722
DOI: 10.1055/s-0030-1256515
Original article

© Georg Thieme Verlag KG Stuttgart · New York

Nurse-administered propofol sedation for endoscopy: a risk analysis during an implementation phase

J.  T.  Jensen1 , P.  Vilmann2 , 3 , T.  Horsted1 , P.  Hornslet3 , U.  Bodtger4 , A.  Banning1 , A.  Hammering1
  • 1Department of Anesthesiology, Gentofte Hospital, University of Copenhagen, Denmark
  • 2Department of Surgery, Herlev Hospital, University of Copenhagen, Denmark
  • 3Department of Same Day Surgery, Endoscopic Unit, Gentofte Hospital, University of Copenhagen, Denmark
  • 4Department of Pulmonary Medicine, Gentofte Hospital, University of Copenhagen, Denmark
Further Information

Publication History

submitted 14 July 2010

accepted after revision 6 March 2011

Publication Date:
02 August 2011 (online)

Background and study aims: The aim of the present study was to perform a risk analysis during the implementation phase of nurse-administered propofol sedation (NAPS) and to validate our structured training program.

Patients and methods: A structured training program was developed both for endoscopists and for endoscopy nurses who were administering propofol sedation. The nurses’ program comprised a 6-week course including theoretical and practical training in airway management, and the endoscopists’ program consisted of 2.5 h of theory and a short course in practical airway management. In the implementation phase, data from 1822 endoscopic procedures in 1764 patients were prospectively collected. All adverse events related to sedation were recorded (defined as oxygen saturation < 92 %, airway handling, assisted ventilation, need for intubation, change in blood pressure > 20 mmHg).

Results: 78 cases of hypoxemia were documented in 1764 patients (4.4 %), in 56/983 upper endoscopies (5.7 %) and 22/754 lower endoscopies (2.9 %) (P = 0.007). Assisted ventilation was necessary in 19 cases (1.1 %) and anesthesiologic assistance was requested 10 times. Two patients required endotracheal intubation. A change in blood pressure was recorded in 451 patients (26 %). Independent risk factors were type of intervention and level of experience of the staff performing the sedation.

Conclusion: These results were obtained after development of a structured training program both for endoscopists and nurses using propofol for sedation, and can be used as basis for further comparison. NAPS for endoscopic procedures is safe when performed by personnel properly trained in airway handling and sedation with propofol, and has considerable advantages compared with conventional sedation for endoscopy.

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P. VilmannMD, DSci 

Department of Same-day Surgery
Endoscopic Unit Z-806
Gentofte Hospital, University of Copenhagen

2900 Hellerup
Denmark

Fax: +45-39-777629

Email: Pevi@geh.regionh.dk