Propofol vs traditional sedatives for sedation in endoscopy: A systematic review and meta-analysis

Figure 1 Flow diagram of included and excluded clinical trials.

Figure 2 Propofol vs benzodiazepine associated with opioid - Forest plot of the meta-analysis. A: Comparing the occurrence of bradycardia between the propofol group and the benzodiazepine + opioid group (BZ + OP). Outcome: Bradycardia (defined as heart rate less than 50 bpm); B: Comparing the occurrence of oxygen desaturation between the propofol group and BZ + OP. Outcome: Hypotension (Defined as systolic blood pressure < 90 mmHg); C: Comparing the occurrence of desaturation between the propofol group and BZ + OP. Outcome: Oxygen desaturation (Defined as peripheral saturation of O₂ defined as < 90%); D: Comparing patient satisfaction with the sedation received for the procedure between the propofol group and BZ + OP. Outcome: Patient satisfaction (Visual analog scale – 0: very dissatisfied to 10: very satisfied); E: Comparing satisfaction of the endoscopists with the sedation administered for the procedure between the propofol group and BZ + OP. Outcome: Endoscopists satisfaction (Visual analog scale – 0: very dissatisfied to 10: very satisfied); F: Comparing patient recovery time after the procedure between the propofol group and BZ + OP. Outcome: Post procedure time to recovery (min).

Figure 3 Propofol vs propofol with benzodiazepine and/or opioids - Forest plot of the meta-analysis. A: Comparing the occurrence of bradycardia between the propofol group and the propofol group associated with benzodiazepine and / or opioid (Prop + BZ and/or OP). Outcome: Bradycardia (defined as HR < 50 bpm); B: Comparing the occurrence of hypotension between the propofol group and (Prop + BZ and/or OP). Outcome: Hypotension (Defined as systolic blood pressure < 90 mmHg); C: Comparing the occurrence of desaturation between the propofol group and Prop + BZ and/or OP. Outcome: Desaturation (Defined as peripheral oxygen saturation of < 90%); D: Comparing patient satisfaction with sedation received for the procedure between propofol group and Prop + BZ and/or OP. Outcome: Patient satisfaction (Visual analog scale - 0 very dissatisfied / 10 very satisfied); E: Comparing patient recovery time after the procedure between the propofol group and Prop + BZ and/or OP. Time to recovery (min); F: Comparing the total dose of propofol administered during procedures between the propofol group and Prop + BZ and/or OP. Outcome: Total dose of propofol given during the procedure (mg).

Figure 4 Propofol associated with benzodiazepine and opioid vs benzodiazepine associated with opioid - Forest plot of the meta-analysis. A: Comparing the occurrence of bradycardia between the benzodiazepine-associated propofol group and the opioid and the benzodiazepine group associated with the opioid (BZ + OP). Outcome: Bradycardia (defined as HR < 50 bpm); B: Comparing the occurrence of hypotension between the benzodiazepine-associated propofol group and the opioid and BZ + OP. Outcome: Hypotension (Systolic blood pressure < 90 mmHg); C: Comparing the occurrence of desaturation between the benzodiazepine-associated propofol group and the opioid and BZ + OP. Outcome: Desaturation (Peripheral saturation of O₂ < 90%).