Background /Aims: The use of moderate to deep sedation for gastrointestinal endoscopic procedures has increased in Europe considerably. Because this level of sedation is a risky medical procedure, a number of international guidelines have been developed. This survey aims to review if, and if so which, quality aspects have been included in new sedation practices when compared to traditional uncontrolled sedation practices.
Methods A questionnaire was sent to the National Associations of Nurse Anesthetists in Europe and the National Delegates of the European Section and Board of Anaesthesiology from January 2012 to August 2012.
Results Huge variation in practices for moderate to deep sedation were identified between and within European countries in terms of safety, type of practitioners, responsibilities, monitoring, informed consent, patient satisfaction, complication registration, and training requirements. Seventy-five percent of respondents were not familiar with international sedation guidelines. Safe sedation practices (mainly propofol-based moderate to deep sedation) are rapidly gaining popularity.
Conclusions The risky medical procedure of moderate to deep sedation has become common practice for gastrointestinal endoscopy. Safe sedation practices requiring adequate selection of patients, adequate monitoring, training of sedation practitioners, and adequate after-care, are gaining attention in a field that is in transition from uncontrolled sedation care to controlled sedation care.
Citations
Citations to this article as recorded by
Nurse-Administered Propofol Sedation Training Curricula and Propofol Administration in Digestive Endoscopy Procedures Andrea Minciullo, Lucia Filomeno Gastroenterology Nursing.2024; 47(1): 33. CrossRef
The effective dose of butorphanol tartrate in patients of different ages undergoing painless gastroscopy Yaorui Sun, Shujiao Liu, Wenli Si, Quanyi Zhang, Fei Yu, Ming Su, Chao Sun Journal of International Medical Research.2024;[Epub] CrossRef
Economic benefits of remimazolam compared to midazolam and propofol for procedural sedation in colonoscopies and bronchoscopies Mikkel H. Pedersen, Anne Danø, Ebbe Englev, Lisbeth Kattenhøj, Emma Munk Current Medical Research and Opinion.2023; 39(5): 691. CrossRef
Comparison of 95% effective dose of remimazolam besylate and propofol for gastroscopy sedation on older patients: A single‐centre randomized controlled trial Enci Ye, Keyang Wu, Hui Ye, Wenyuan Zhang, Lihua Chu, Kai Zhang, Guohao Xie, Yue Jin, Xiangming Fang British Journal of Clinical Pharmacology.2023; 89(11): 3401. CrossRef
The effectiveness of esketamine and propofol versus dezocine and propofol sedation during gastroscopy: A randomized controlled study Yafei Xu, Yuling Zheng, Tianying Tang, Lvlv Chen, Yiwen Zhang, Zhongqi Zhang Journal of Clinical Pharmacy and Therapeutics.2022; 47(9): 1402. CrossRef
Effect of intravenous lidocaine on the ED50 of propofol for inserting gastroscope without body movement in adult patients: a randomized, controlled study Xiu-Ru Qi, Jing-Yi Sun, Li-Xin An, Ke Zhang BMC Anesthesiology.2022;[Epub] CrossRef
The median effective doses of propofol combined with two different doses of nalbuphine for adult patients during painless gastroscopy Lili Tang, Chenxuan Ye, Nan Wang, Chen Chen, Sirui Chen, Shan Gao, Xuesheng Liu Frontiers in Pharmacology.2022;[Epub] CrossRef
Evaluation of 30-day mortality in patients undergoing gastrointestinal endoscopy in a tertiary hospital: a 3-year retrospective survey Olivier Chatelanat, Laurent Spahr, Philippe Bichard, Laurent Bochatay, Nicolas Goossens, Caroline Bastid, Jean-Louis Frossard BMJ Open Gastroenterology.2022; 9(1): e000977. CrossRef
Effective dose of propofol combined with a low-dose esketamine for gastroscopy in elderly patients: A dose finding study using dixon’s up-and-down method Yuling Zheng, Yafei Xu, Bixin Huang, Ying Mai, Yiwen Zhang, Zhongqi Zhang Frontiers in Pharmacology.2022;[Epub] CrossRef
Estimation of effective dose of propofol mono‐sedation for successful insertion of upper gastrointestinal endoscope in healthy, non‐obese Chinese adults Fu K. Liu, Lei Wan, Liu J. Z. Shao, Yi Zou, Shao H. Liu, Fu S. Xue Journal of Clinical Pharmacy and Therapeutics.2021; 46(2): 484. CrossRef
Confocal laser endomicroscopy under propofol‐based sedation for early gastric cancer and pre‐cancerous lesions is associated with better diagnostic accuracy: a retrospective cohort study in China Lihua Chu, Jialian Zhao, Cheng Sheng, Min Yue, Feifei Wang, Shengwen Song, Baoli Cheng, Guohao Xie, Xiangming Fang BMC Anesthesiology.2021;[Epub] CrossRef
A plea for a unified approach to sedation in gastrointestinal endoscopy in Romania: results from a prospective multicentric trial Theodor Voiosu, Tudor Moga, Cristian Nedelcu, Cristina Tocia, Monica State, Claudia Puscasu, Andreea Bengus, Andrei Voiosu, Lucian Negreanu, Eugen Dumitru, Gabriel Constantinescu, Bogdan Mateescu, Ioan Sporea Romanian Journal of Internal Medicine.2021; 59(3): 303. CrossRef
Efficacy and Safety of a Novel Mouthpiece for Esophagogastroduodenoscopy: A Multi-Center, Randomized Study Yuichiro Ikebuchi, Kazuya Matsumoto, Naoki Ueda, Taro Yamashita, Hiroki Kurumi, Takumi Onoyama, Yohei Takeda, Akira Yoshida, Koichiro Kawaguchi, Kazuo Yashima, Kazunori Fujiwara, Ryu Imamoto, Hisashi Noma, Masaru Ueki, Hajime Isomoto Diagnostics.2021; 11(3): 538. CrossRef
Safety and Recipient Satisfaction of Propofol Sedation in Outpatient Endoscopy: A 24-Hour Prospective Investigation Using a Questionnaire Survey Yoshihide Kanno, Tetsuya Ohira, Yoshihiro Harada, Shinsuke Koshita, Takahisa Ogawa, Hiroaki Kusunose, Yoshiki Koike, Taku Yamagata, Toshitaka Sakai, Kaori Masu, Keisuke Yonamine, Kazuaki Miyamoto, Megumi Tanaka, Tomohiro Shimada, Fumisato Kozakai, Kazuki Clinical Endoscopy.2021; 54(3): 340. CrossRef
Propofol versus midazolam with or without short-acting opioids for sedation in colonoscopy: a systematic review and meta-analysis of safety, satisfaction, and efficiency outcomes Fahima Dossa, Braeden Medeiros, Christine Keng, Sergio A. Acuna, Nancy N. Baxter Gastrointestinal Endoscopy.2020; 91(5): 1015. CrossRef
A survey on colonoscopy shows poor understanding of its protective value and widespread misconceptions across Europe Bharat Amlani, Franco Radaelli, Pradeep Bhandari, Magdalena Grce PLOS ONE.2020; 15(5): e0233490. CrossRef
Nonoperating room anesthesia in different parts of the world Claudia Fernandez-Robles, Adriana D. Oprea Current Opinion in Anaesthesiology.2020; 33(4): 520. CrossRef
A Prospective Study of Factors Associated with Abdominal Pain in Patients during Unsedated Colonoscopy Using a Magnifying Endoscope Hiroto Suzuki, Masanao Nakamura, Takeshi Yamamura, Keiko Maeda, Tsunaki Sawada, Yasuyuki Mizutani, Takuya Ishikawa, Kazuhiro Furukawa, Eizaburo Ohno, Takashi Honda, Hiroki Kawashima, Masatoshi Ishigami, Mitsuhiro Fujishiro Internal Medicine.2020; 59(15): 1795. CrossRef
A focused ethnography of how endoscopy practitioners utilize capnography in sedated patients Deemah Nassir Aldossary, Sherran Milton Qualitative Research in Medicine and Healthcare.2020;[Epub] CrossRef
Assessment of sedation level for endoscopic retrograde cholangiopancreatography – a prospective validation study Jarno Jokelainen, Harri Mustonen, Leena Kylänpää, Marianne Udd, Outi Lindström, Reino Pöyhiä Scandinavian Journal of Gastroenterology.2018; 53(3): 370. CrossRef
Do we really need an anesthesiologist for routine colonoscopy in American Society of Anesthesiologist 1 and 2 patients? Joshua W. Sappenfield, Jeffrey D. White Current Opinion in Anaesthesiology.2018; 31(4): 463. CrossRef
Sedation for gastrointestinal endoscopy in Australia Kate Leslie, James Sgroi Current Opinion in Anaesthesiology.2018; 31(4): 481. CrossRef
Paradigm shift: should the elderly undergo propofol sedation for DBE? A prospective cohort study Hey-Long Ching, Federica Branchi, David S Sanders, David Turnbull, Reena Sidhu Frontline Gastroenterology.2018; 9(3): 192. CrossRef
Making sense of propofol sedation for endoscopy J.R. Sneyd British Journal of Anaesthesia.2017; 118(1): 6. CrossRef
Safety of deep sedation in the endoscopy suite Megan L. Allen Current Opinion in Anaesthesiology.2017; 30(4): 501. CrossRef
Sedation-related Adverse Events Associated with a Diagnostic Upper Endoscopy: A Single Center-observational Study Jihyun Lee, Ki-Nam Shim, Kang Hoon Lee, Ko Eun Lee, Ji Young Chang, Chung Hyun Tae, Chang Mo Moon, Seong-Eun Kim, Hye-Kyung Jung, Sung-Ae Jung The Korean Journal of Helicobacter and Upper Gastrointestinal Research.2017; 17(4): 185. CrossRef
Nonoperating room anesthesia for endoscopic procedures Stephan Knigge, Klaus Hahnenkamp Current Opinion in Anaesthesiology.2017; 30(6): 652. CrossRef
Remimazolam: A New Ultra Short Acting Benzodiazepine
Journal of Anesthesia & Critical Care: Open Access.2016;[Epub] CrossRef