Propofol versus remifentanil sedation for elective gastroscopy: a randomized controlled trial
- 1University of Health Sciences, Fatih Sultan Mehmet Training and Research Hospital, Department of Anesthesiology and Reanimation – Istanbul, Turkiye.
Abstract
SUMMARY: OBJECTIVE:: Propofol and remifentanil are widely used for elective gastroscopy sedation. The aim of this randomized controlled trial was to compare their safety profiles, patient-reported recovery quality, and endoscopist satisfaction.
METHODS:: This single-center randomized controlled trial enrolled 88 adults (American Society of Anesthesiologists I–III) undergoing elective gastroscopy, allocated 1:1 to propofol (Group P, n=44) or remifentanil (Group R, n=44). Sedation depth was standardized using the Bispectral Index (target 60–80) and Ramsay Sedation Scale (target 2–3). The primary outcome was the Quality of Recovery-15 score at 30 min post-procedure; secondary outcomes included complication incidence, awakening time, and endoscopist satisfaction.
RESULTS:: Quality of Recovery-15 scores were comparable (median 140 vs. 140; median difference 0, 95%CI -1.0 to 1.0; p=0.95). Total complication incidence was 0% in Group P versus 61.4% in Group R (p<0.001), comprising bradycardia (27.3%), postoperative nausea and vomiting (20.5%), and desaturation (13.6%). Awakening time was shorter in Group R (3 vs. 60 s; p<0.001). Endoscopist satisfaction was significantly higher in Group P (90.9 vs. 56.8% excellent scores; p=0.003).
CONCLUSION:: Despite comparable patient-reported recovery quality, propofol was associated with substantially fewer perioperative adverse events (0 vs. 61.4%) and higher endoscopist satisfaction, supporting its preferential use in routine elective gastroscopy sedation.
Clinical Trial Registration Number:: ClinicalTrials.gov, NCT07336628. Registered January 2, 2026.
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BibTeX
@article{ofluoglu2026propofol,
title = {{Propofol versus remifentanil sedation for elective gastroscopy: a randomized controlled trial}},
author = {Cansu Ofluoğlu and Doğa Meriç Yükselen and Arsen Güngör Ay and Ayşe Günler Gayretli and Öznur Demiroluk and Arzu Yıldırım Ar},
journal = {Revista da Associacao Medica Brasileira (1992)},
year = {2026},
month = oct,
doi = {10.1590/1806-9282.20260891},
url = {https://europepmc.org/article/PMC/PMC13711639},
note = {CC BY},
}
RIS
TY - JOUR
TI - Propofol versus remifentanil sedation for elective gastroscopy: a randomized controlled trial
AU - Cansu Ofluoğlu
AU - Doğa Meriç Yükselen
AU - Arsen Güngör Ay
AU - Ayşe Günler Gayretli
AU - Öznur Demiroluk
AU - Arzu Yıldırım Ar
PY - 2026
DA - 2026/10/23
JO - Revista da Associacao Medica Brasileira (1992)
DO - 10.1590/1806-9282.20260891
UR - https://europepmc.org/article/PMC/PMC13711639
AB - SUMMARY: OBJECTIVE:: Propofol and remifentanil are widely used for elective gastroscopy sedation. The aim of this randomized controlled trial was to compare their safety profiles, patient-reported recovery quality, and endoscopist satisfaction. METHODS:: This single-center randomized controlled trial enrolled 88 adults (American Society of Anesthesiologists I–III) undergoing elective gastroscopy, allocated 1:1 to propofol (Group P, n=44) or remifentanil (Group R, n=44). Sedation depth was standardized using the Bispectral Index (target 60–80) and Ramsay Sedation Scale (target 2–3). The primary outcome was the Quality of Recovery-15 score at 30 min post-procedure; secondary outcomes included complication incidence, awakening time, and endoscopist satisfaction. RESULTS:: Quality of Recovery-15 scores were comparable (median 140 vs. 140; median difference 0, 95%CI -1.0 to 1.0; p=0.95). Total complication incidence was 0% in Group P versus 61.4% in Group R (p<0.001), comprising bradycardia (27.3%), postoperative nausea and vomiting (20.5%), and desaturation (13.6%). Awakening time was shorter in Group R (3 vs. 60 s; p<0.001). Endoscopist satisfaction was significantly higher in Group P (90.9 vs. 56.8% excellent scores; p=0.003). CONCLUSION:: Despite comparable patient-reported recovery quality, propofol was associated with substantially fewer perioperative adverse events (0 vs. 61.4%) and higher endoscopist satisfaction, supporting its preferential use in routine elective gastroscopy sedation. Clinical Trial Registration Number:: ClinicalTrials.gov, NCT07336628. Registered January 2, 2026.
SN - 0104-4230
SN - 1806-9282
ER -