Psychomotor recovery and blood propofol level in colonoscopy when using propofol sedation

BackgroundIt is commonly recommended that patients refrain from driving for 24 hours after endoscopy for which sedation is given.ObjectiveThe aim of this study was to evaluate psychomotor recovery and blood propofol concentrations after colonoscopy with propofol sedation to determine whether driving might be safe.DesignA prospective, consecutive study.SettingMunicipal hospital outpatients.PatientsThis study involved 48 consecutive patients scheduled for colonoscopy with propofol sedation.InterventionPatient clinical features, psychomotor recovery, and blood concentrations of propofol were assessed. Psychomotor recovery was assessed before colonoscopy and 1 and 2 hours after colonoscopy by using the number connection test and a driving simulator test.Main Outcome MeasurementsClinical features, psychomotor recovery, and blood concentration of propofol.ResultsAll patients successfully completed the post-sedation assessments. Although there was a significant difference in results of the number connection test between before colonoscopy and 1 hour after colonoscopy, all number connection test results were within normal limits (<40 seconds). Scores were as follows: mean time (standard deviation) before colonoscopy, 32.2 (2.0) seconds (range 29-36 seconds) versus after colonoscopy, 32.7 (2.0) seconds (range 27-38 seconds); P = .0019. Driving skills had recovered to the baseline levels 1 hour after colonoscopy. Scores were as follows: tracking error (%) before colonoscopy, 45.0 (5.6) versus after colonoscopy, 46.0 (5.5); P = .61; accelerating reaction time in seconds before colonoscopy, 0.65 (0.15) versus after colonoscopy, 0.62 (0.14); P = .40; braking reaction time in seconds before colonoscopy, 0.58 (0.13) versus after colonoscopy, 0.61 (0.13); P = .50.LimitationsSmall sample size, single-center study.ConclusionAlthough consistent findings on the number connection test and driving simulation (psychomotor recovery) test are present as early as 1 hour after propofol sedation, a study of additional numbers of patients as well as different patient populations are needed before these results can be universally recommended.