Original Paper

Safety and Driving Ability following Low-Dose Propofol Sedation
Akira Horiuchi^a, Yoshiko Nakayama^b, Yoshihiko Katsuyama^c, Shigeru Ohmori^c, Yasuyuki Ichise^a, Naoki Tanaka^a

Departments of
^aGastroenterology and
^bPediatrics, Showa Inan General Hospital, Komagane, and
^cDivision of Pharmacy, Shinshu University Hospital, Matsumoto, Japan

Address of Corresponding Author

Digestion 2008;78:190-194 (DOI: 10.1159/000187118)

  Key Words

• Propofol
• Sedation
• Esophagogastroduodenoscopy
• Driving ability
• EGD

  Abstract

Background and Aim: Automobile driving is prohibited after midazolam sedation because of the slow recovery of psychomotor function. This study prospectively assessed the safety of low-dose propofol sedation (study 1) and compared driving ability following propofol and midazolam sedation (study 2). Methods: Study 1: We prospectively investigated bolus injection of a low-dose of propofol (40-80 mg for <70 years and 30 mg for 70 years) for diagnostic esophagogastroduodenoscopy (EGD). Respiratory depression, time to full recovery, and overall patient satisfaction were evaluated and blood concentrations of propofol were measured. Study 2: A subset of subjects undergoing diagnostic EGD were randomized to receive 40 mg of propofol (n = 30), 4 mg of midazolam (n = 30) or no sedation controls (n = 20), and the residual effects of each drug were tested using a driving simulator. The primary outcome measure was driving ability. The second outcome measures were overall patient satisfaction and complications. Results: Study 1: Only 1.1% of 12,031 healthy subjects developed transient oxygen desaturation. Full recovery was present in 97.5% 30 min after the procedure; 99.8% were willing to repeat the same procedure. The blood levels of propofol (40-80 mg) at 60 min were <100 ng/ml. Study 2: Driving ability recovered to the basal level within 60 min of propofol administration but not with 120 min with midazolam. There were no complications; overall patient satisfaction was similar between propofol and midazolam (8.9 vs. 8.5, p = 0.34). Conclusion: Low-dose propofol sedation was safe and recovery including driving ability was with 60 min.

Copyright © 2008 S. Karger AG, Basel

  Author Contacts

Akira Horiuchi, MD
Department of Gastroenterology
Showa Inan General Hospital
3230 Akaho, Komagane 399-4191 (Japan)
Tel. +81 265 82 2121, Fax +81 265 82 2118, E-Mail horiuchi.akira@sihp.jp

  Article Information

Received: September 15, 2008
Accepted: October 27, 2008
Published online: December 18, 2008
Number of Print Pages : 5
Number of Figures : 1, Number of Tables : 3, Number of References : 19