We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Research Letter |

Propofol for Screening Colonoscopy in Low-Risk Patients:  Are We Paying Too Much?

Deepak Agrawal, MD, MPH1; Don C. Rockey, MD2
[+] Author Affiliations
1Division of Digestive and Liver Diseases, University of Texas Southwestern Medical Center, Dallas
2Department of Internal Medicine, Medical University of South Carolina, Charleston
JAMA Intern Med. 2013;173(19):1836-1838. doi:10.1001/jamainternmed.2013.8417.
Text Size: A A A
Published online


Use of propofol for sedation for screening colonoscopy in low-risk patients has increased markedly recently.1,2 In the United States, propofol is administered only by an anesthesiology provider, which can substantially increase cost (typically $600-$2000). Given the number of screening colonoscopies performed every year, additional health care costs associated with this practice are substantial. The advantages of propofol over standard moderate sedation using a narcotic and/or benzodiazepine include quicker onset of action, a shorter half-life, and deeper level of sedation. However, evidence supporting the potential benefits of propofol is limited.3 For screening colonoscopy in low-risk patients, the question thus becomes, what is propofol worth? For a patient who has never had a colonoscopy, this is a very difficult question to answer, since it is challenging to associate a dollar amount to comfort without knowledge of the likely degree of discomfort. Hence, we approached this question by asking those who are most familiar with colonoscopy and sedation medications—namely gastroenterologists and endoscopy nurses.

Figures in this Article

Sign in

Create a free personal account to sign up for alerts, share articles, and more.

Purchase Options

• Buy this article
• Subscribe to the journal

First Page Preview

View Large
First page PDF preview


Place holder to copy figure label and caption
Euler Diagrams Depicting Provider Reasons for Preferring Propofol

A, Gastroenterologists (n = 451). B, Endoscopy nurses (n = 460). The color-coded panel shows the key for the specific preference reasons. The letters represent a key for the specific reasons, and the numbers given represent percentages.

Graphic Jump Location




Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
Submit a Comment


Some tools below are only available to our subscribers or users with an online account.

Sign in

Create a free personal account to sign up for alerts, share articles, and more.

Purchase Options

• Buy this article
• Subscribe to the journal

Related Content

Customize your page view by dragging & repositioning the boxes below.

Articles Related By Topic
Related Collections
PubMed Articles

Users' Guides to the Medical Literature
Clinical Resolution

Users' Guides to the Medical Literature
Adverse effects of colonoscopy are one of the main risks of CRC screening. Data from the UK trial...