DOI: https://doi.org/10.36347/sjmcr.2026.v14i06.063

Pages: 1603-1609

Background: Propofol is currently considered the sedative agent of choice for digestive endoscopy because of its rapid onset and favorable recovery profile. However, the optimal administration technique remains controversial. Target-controlled infusion (TCI) may offer better control of sedation depth than intermittent bolus administration by maintaining stable effect-site concentrations. Objective: To compare the efficacy and safety of propofol administered through target-controlled infusion versus intermittent bolus injection during elective digestive endoscopy. Methods: A retrospective observational comparative study was conducted at the Digestive Endoscopy Unit of the 5th Medical-Surgical Center of Errachidia, Morocco, between January and April 2026. Eighty ASA I–II patients undergoing elective esophagogastroduodenoscopy (EGD), colonoscopy, or combined procedures under propofol sedation were included. Forty patients received sedation using a target-controlled infusion system (TCI group), whereas forty received intermittent intravenous boluses of propofol (Bolus group). The primary endpoint was recovery time. Secondary endpoints included hemodynamic and respiratory adverse events, total propofol consumption, procedural duration, fentanyl requirement, and sedation quality. Results: Baseline demographic and clinical characteristics were comparable between groups. Recovery time was significantly shorter in the TCI group than in the Bolus group (7 [5–10] vs. 16 [10–20] minutes, p = 0.01). Procedure duration was also significantly reduced in the TCI group (31 [25–56] vs. 38 [32–56] minutes, p = 0.01). Although median propofol consumption was lower in the TCI group (455 [400–620] mg vs. 490 [420–670] mg), the difference did not reach statistical significance (p = 0.086). Tachycardia (0% vs. 15%, p = 0.012), hypotension (5% vs. 22%, p = 0.033), and oxygen desaturation (0% vs. 15%, p = 0.012) occurred more frequently in the Bolus group. Sedation quality was significantly