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Chapter 12
ABSTRACT
Introduction:
Propofol provides excellent sedation during colonoscopies. However, its use is
associatedwith cardiopulmonary depressions. Acupuncture is nowadays used for treatment
of pain, anxiety, and also to induce sedation. We hypothesised that electro-acupuncture
during colonoscopies has sedative effects, thereby reducing propofol requirements to
achieve an adequate level of sedation.
Method:
The study was performed as a single centre, patient and observer blinded, sham-
and placebo-controlled randomised trial. Patients scheduled for elective colonoscopy under
deep propofol/alfentanil sedation were randomly assigned to receive electro-acupuncture
(EA), sham-acupuncture (SA), or placebo-acupuncture (PA) at ST36, PC6, and LI4. Primary
outcome parameter was the total dosage of propofol. Secondary objective was patients’
and endoscopists’ satisfaction level evaluated by questionnaires.
Results
: The dosage of propofol (median (IQR)) was not significantly different between the
three groups [group EA 147 mcg/kg/min (109-193) vs. group SA 141 mcg/kg/min (123-180)
vs. group PA 141 mcg/kg/min (112-182); p=0.776]. There was also no significant difference
in alfentanil consumption (p=0.634). Global satisfaction (median (IQR)) among patients
[group EA 6.6 (6.0-7.0) vs. group SA 6.8 (6.0-7.0) vs. group PA 6.5 (6.0-7.0); p=0,481] and
endoscopists [in all groups 6.0 (5.0-6.0), p=0.773] did not significantly differ between the
three groups. There was no significant difference in the number of cardiorespiratory events.
Conclusion:
For colonoscopy, electro-acupuncture did not show any propofol-sparing
sedative effect compared with sham or placebo acupuncture.
Trial registration:
The trial is registered in the Netherland’s Trial Registration (NTR4325).