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 26 February 2018

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News

Patterns of sedation and monitoring during endoscopy

The use of sedation in gastrointestinal endoscopy has markedly increased over the last 13 years and the use of electronic monitoring has become standard practice, reports February's issue of Endoscopy.

News image

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Little is known about how practices in sedation and in monitoring during gastrointestinal endoscopy and the complication rates of sedation have changed over time.

Dr Heuss and colleagues from Switzerland undertook a nationwide survey in order to assess the present practice among Swiss gastroenterologists.

The researchers focused particularly on the use of propofol, and they compared the results with similar data obtained in 1990.

At the end of 2003, the research team sent a questionnaire (similar to the one used in 1990) to all 249 Swiss gastroenterologists.

The response rate was 72%.

The researchers then analyzed data from 179,953 endoscopies performed during the previous 12 months.

Overall sedation-related morbidity was 0.2 % and the mortality rate was 0.0014 %
Endoscopy

The researchers found that in 2003 sedation was used in 78 % of esophagogastroduodenoscopies and colonoscopies (compared with 60 % in 1990).

In addition, they found that midazolam was the most commonly used medication.

The research team noted that the drugs were mostly administered by the endoscopy nurse, via an intravenous cannula.

Oximetry monitoring was used in more than 95 % of examinations (compared with 3 % in 1990).

The researchers found that the overall sedation-related morbidity was 0.2 % and the mortality rate was 0.0014 %.

Of the 180 respondents, 77 (43 %) reported that they been using propofol regularly for a median time period of 23 months.

The research team noted that the 34 % respondents who used propofol without the assistance of an anesthesiologist had performed a total of 82, 620 procedures.

The morbidity (defined as the need for bag-ventilation) in this group of patients was 0.2 % and no deaths were reported.

Dr Heuss concluded, "The use of sedation in gastrointestinal endoscopy has markedly increased over the last 13 years and the use of electronic monitoring has become standard practice."

"A significant percentage of Swiss gastroenterologists report that they use propofol, mainly in a hospital setting."

Endoscopy; 2005; 37: 161-166
07 February 2005

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