When Should Propofol Be Used in GI Endoscopy?
Within the past few years, two different strategies have been developed for using propofol in GI endoscopy. First, by emphasizing its origin as an anesthetic agent and its potential to easily achieve deep sedation, some authors have suggested reserving propofol for prolonged and difficult endoscopic procedures, i.e. using the drug primarily for its superior hypnotic potency [17, 18, 45]. Using this strategy, propofol becomes a second-line drug that can replace the need for having an anesthesiologist, and is reserved for difficult procedures. This enables gastroenterologists to perform endoscopic interventions while patients are in a quiet state of (deep) sedation. Underscoring its pharmacokinetic properties, other authors have introduced the substance as a routine first-line hypnotic for all EGD and colonoscopies, providing special benefits in an outpatient setting [22, 37, 46, 47]. With this view, its rapid re-awakening and metabolism are major benefits for the physician who strives f
