Comparison of bolus versus continuous infusion of propofol for procedural sedation: a meta-analysis

Abstract

Objective: To compare the efficacy and safety of bolus infusion versus continuous infusion for propofol sedation.

Methods: We searched OVID-MEDLINE, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), Google Scholar, Koreamed, and Kmbase databases to identify all randomized controlled trials that compared bolus infusion with continuous infusion for propofol sedation. We evaluated propofol dose used, procedure, sedation, and recovery time. The incidences of respiratory and cardiovascular complications were also evaluated.

Results: A total of 12 studies of 963 patients were included. The required propofol dose was significantly higher in continuous infusion compared with bolus infusion (standardized mean difference [SMD]: −0.44; 95% confidence interval [CI]: −0.71 to −0.16; I² = 84%). Sedation time was significantly longer in continuous infusion compared with bolus infusion (mean difference [MD]: −8.58 min; 95% CI: −15.13 to −2.03; I² = 44%). The recovery time and incidences of desaturation, airway intervention, hypotension, and bradycardia were comparable between bolus and continuous infusion.

Conclusions: Propofol sedation by continuous infusion required a higher dose of propofol compared with bolus infusion, but the recovery time and frequency of complications were similar.

Keywords:

• Bolus infusion
• continuous infusion
• meta-analysis
• propofol
• sedation

Transparency

Declaration of funding

This research was supported by the Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education, Science and Technology (NRF-2015R1A2A2A01005153).

Author contributions: G.J.C. designed the study, conducted the study (selected study, extracted data), analyzed and interpreted the data, and wrote the manuscript; H.K. designed the study, conducted the study (extracted data), analyzed and interpreted the data, and wrote the manuscript; C.W.B. conducted the study (helped to select study and extract data, assessed the risk of bias), and provided critical revision of the manuscript; Y.H.J. conducted the study (helped to select study and extract data, assessed the risk of bias, and provided critical revision of the manuscript; J.J.L. conducted the study (selected study), analyzed the data and wrote the manuscript; all authors approved the final manuscript.

Declaration of financial/other relationships

G.J.C., H.K., C.W.B., Y.H.J. and J.J.L. have disclosed that they have no significant relationships with or financial interests in any commercial companies related to this study or article.

CMRO peer reviewers on this manuscript have received an honorarium from CMRO for their review work, but have no relevant financial or other relationships to disclose.

Acknowledgements

No assistance in the preparation of this article is to be declared.