Propofol target-controlled infusion for gastrointestinal endoscopy

Abstract

Gastrointestinal endoscopy, which includes procedures such as esophagogastroduodenoscopy, colonoscopy, endoscopic ultrasound, and endoscopic retrograde cholangiopancreatography, has become an increasingly routine part of cancer preventive care for the digestive system. Target-controlled infusion (TCI) has revolutionized total intravenous anesthesia by enabling precise control over the delivery of sedative and analgesic agents. This technique, often used with propofol or a combination of propofol and other agents like midazolam and fentanyl, facilitates personalized sedation that considers factors such as sex, age, body height, and weight. By employing TCI for endoscopy, clinicians can customize the dosage of sedative agents to meet the needs of each patient, ensuring optimal sedation and comfort. To date, the application of TCI in gastrointestinal endoscopy has not been standardized, and no review has covered its potential to provide safe sedation during these procedures. The present review explores the fundamentals of this technique and its use in gastrointestinal endoscopy, including the selection of drugs for TCI, the determination of the optimal dose for TCI target concentration, and a comparison of TCI with other sedation methods.

Keywords

• colonoscopy; endoscopy
• gastrointestinal; propofol; target-controlled infusion; total intravenous anesthesia