Gastroenterology Research and Practice

Review Article

Safety of Propofol versus Nonpropofol-Based Sedation in Children Undergoing Gastrointestinal Endoscopy: A Systematic Review and Meta-Analysis

Table 1

Detail summarizing the 3 randomized controlled trials and 4 prospective studies included in the meta-analysis.


Study	Age	Procedure	Treatment arms		Dose	Adverse events ()
Study	Age	Procedure	Treatment arms		Dose	Bradycardia	Hypotension	Desaturation	Respiratory depression	Total airway

Singh et al., 1996 [17] Prospective cohort (abstract)	4–15	Endoscopy, colonoscopy	Propofol	50	3–3.5 mg/kg				2 (apnea)
Singh et al., 1996 [17] Prospective cohort (abstract)	4–15	Endoscopy, colonoscopy	Propofol + diazemul or pentazocine	50	Propofol 2.5–3 mg/kg, diazemul 2.5 mg, pentazocine 5 mg				2 (apnea)

Barbi et al., 2003 [18] RCT (full text)	0.5–17	Upper GI	Propofol	60	n/a		27	8
Barbi et al., 2003 [18] RCT (full text)	0.5–17	Upper GI	Propofol + ketamine	62	n/a		17	9

Paspatis et al., 2006 [19] RCT (full text)	3–17	Upper GI	Propofol	28	0.5 mg/kg repeat doses	4	1	6
Paspatis et al., 2006 [19] RCT (full text)	3–17	Upper GI	Propofol + midazolam premed (PO)	26	Propofol: 0.5 mg/kg repeat doses (max 20 mg)	4	0	4

Hammer et al., 2009 [20] Prospective cohort (full text)	3–10	EGD	Propofol	12	Avg: 2.8–4 mcg/ml	0	2		4
Hammer et al., 2009 [20] Prospective cohort (full text)	3–10	EGD	Propofol + dexmedetomidine	12	Dex: bolus (10 min) 1 mcg/kg; maintenance: 0.5 mcg/kg/hr; propofol: avg 2.8–4 mcg/ml	3	0		1

Hasanin and Sira 2014 [21] RCT (full text)	1–14	Upper and lower endoscopy	Propofol	40	Bolus: 2 mg/kg; maintenance:100 mcg/kg/min	0	0	6	0
Hasanin and Sira 2014 [21] RCT (full text)	1–14	Upper and lower endoscopy	Dexmedetomidine	40	Bolus: 2.5 mcg/kg; maintenance: 2 mg/kg/hr	0	0	0	0

Garah et al., 2015 [22] Prospective cohort (full text)	1–18	Upper endoscopy, colonoscopy, both	Propofol	5						IPI 1 (IQR 6)
			Propofol + midazolam	89						IPI 7 (IQR 2)
			Propofol + midazolam fentanyl	15						IPI 7 (IQR 2)

Prunty et al., 2015 [23] Prospective cohort (abstract)	n/a	EGD	Propofol	83				3	0	33
Prunty et al., 2015 [23] Prospective cohort (abstract)	n/a	EGD	Propofol + glycopyrrolate + fentanyl + midazolam	129				15	2	17

EGD: esophagogastroduodenoscopy. Definition of hypotension: mean arterial pressure (MAP) decrease of >20 mm hg; definition of desaturation: SpO2 < 92%. Definition of bradycardia: 20% decrease in heart rate; definition of hypotension: MAP decrease > 10 mm hg; definition of desaturation: hypoxemia < 92% for 10 seconds.