Effect of Aminophylline on Incidence of Apnea and Recovery Time during ‎Propofol Sedation for ‎Gastrointestinal Endoscopy

Background: Apnea may occur during propofol sedation for ‎endoscopy, which can be harmful to the patient and disruptive to ‎the procedure.‎
Objective: To test the hypothesis that a small dose of ‎aminophylline before propofol sedation may result in a lower ‎incidence of apnea, as well as faster emergence from sedation. ‎
Patients and Methods: The researchers conducted a single-center, ‎prospective randomized controlled study on 76 adult ASA I or II ‎patients with age ranged from 20 to 65 years old. They were admitted for upper ‎gastrointestinal or colonoscopic endoscopies‎. All patients were ‎sedated with 25µg fentanyl, 1mg/kg propofol bolus over 30 ‎seconds, then propofol boluses (0.5 mg/kg) according to need. ‎Patients were divided into two groups: Control group [Group C ‎‎(n=38)], and a study group [Group Am (n=38)] who received 0.5 ‎mg/kg aminophylline preoperatively. Apneas were counted ‎during each procedure, and emergence from sedation was ‎assessed with modified Aldrete score.‎
Results: There was a statistically significant decrease in the ‎overall incidence of apneas with aminophylline premedication (P ‎ = 0.025), as well as a reduction in the number of apneas ‎per bolus of propofol (P = 0.006). However, there was no ‎statistically significant difference regarding the average time to ‎modified Aldrete score both when tested after 5 minutes or after ‎‎10 minutes after discharge from ‎the endoscopy room.‎
Conclusion: Premedication with a small dose of intravenous ‎aminophylline significantly reduces the incidence of apnea ‎during propofol sedation for gastrointestinal endoscopies, while ‎its effect on emergence from sedation is not significant.‎