Computer-assisted personalized sedation for upper endoscopy and colonoscopy: a comparative, multicenter randomized study

Abstract

Background: The SEDASYS System is an investigational computer-assisted personalized sedation system integrating propofol delivery with patient monitoring to enable endoscopist/nurse teams to safely administer propofol.

Objective: To compare the safety and effectiveness of the SEDASYS System to the current standard of care for sedation during routine endoscopic procedures.

Design: Nonblinded multicenter randomized comparative study.

Setting: Four ambulatory surgery centers, 3 endoscopy centers, and 1 academic center in the United States.

Patients: One thousand American Society of Anesthesiologists physical status class I to III adults undergoing routine colonoscopy or EGD.

Interventions: Sedation with the SEDASYS System (SED) and sedation with each site's current standard of care (CSC; benzodiazepine/opioid combination).

Main outcome measurements: Area under the curve of oxygen desaturation was the primary endpoint. Secondary endpoints included patient satisfaction, clinician satisfaction, level of sedation, and patient recovery time.

Results: Four hundred ninety-six patients were randomized to SED and 504 to CSC. Area under the curve of oxygen desaturation was significantly lower for SED (23.6 s·%) than for CSC (88.0 s·%; P = .028). Patients were predominately minimally to moderately sedated in both groups. SED patients were significantly more satisfied than CSC patients (P = .007). Clinician satisfaction was greater with SED than with CSC (P < .001). SED patients recovered faster than CSC patients (P < .001). The incidence of adverse events was 5.8% in the SED group and 8.7% in the CSC group.

Limitations: Nonblinded.

Conclusions: The SEDASYS System could provide endoscopist/nurse teams a safe and effective on-label means to administer propofol to effect minimal to moderate sedation during routine colonoscopy and EGD.

Trial registration: ClinicalTrials.gov NCT00452426.