Propofol Sedation for Colonoscopy in Middle Eastern Countries

Colonoscopy is typically performed with sedation. Intravenous benzodiazepines with or without opioids have long been used to induce sedation for both colonoscopy and more complex endoscopic procedures. In recent years, we have observed a rapid transformation from the use of opioids and benzodiazepines to sedation with propofol in Western countries.1 However, most endoscopy centers in the Middle East still use traditional sedation with opioids and benzodiazepines for endoscopy. The safety, feasibility and effectiveness of propofol sedation for endoscopic procedures have been well studied in Western countries.2-6 In this issue of “Middle East Journal of Digestive Diseases”, Ghadir MR and colleagues investigated the role of propofol to induce deep sedation in an endoscopy center in Iran.7 In this uncontrolled study, the authors induced sedation with propofol for colonoscopy in 125 patients. Of these, 5.6% developed hypoxemia during colonoscopy. All hypoxemia episodes were successfully controlled by administration of nasal oxygen without the need for mechanical ventilation.