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Moderate sedation using benzodiazepines and opioids continues to be widely used, but propofol sedation is becoming more popular because its unique pharmacokinetic properties make endoscopy almost painless, with a very predictable and rapid recovery process. There is controversy as to whether propofol should be administered only by anesthesia professionals. According to published values, endoscopist\u2010directed propofol has a lower mortality rate than endoscopist\u2010delivered benzodiazepines and opioids, and a comparable rate to general anesthesia by anesthesiologists. Rapid recovery has a major impact on patient satisfaction, post\u2010procedure education and the general flow of the endoscopy unit. According to estimates, the absolute economic benefit of endoscopist\u2010directed propofol implementation in a screening setting is probably substantial, with 10\u2010year savings of $3.2 billion in the USA. 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