Abstract
Sedation is the drug-induced reduction of a patient's consciousness. The aim of sedation in endoscopic procedures is to increase the patient's comfort and to improve endoscopic performance, especially in therapeutic procedures. The most commonly used sedation regimen for conscious sedation in gastrointestinal endoscopy is still the combination of benzodiazepines with opioids. However, the use of propofol has increased enormously in the past decade and several studies show advantages of propofol over the traditional regimes in terms of faster recovery time. It is important to be aware that the complication rate of endoscopies increases when sedation is used; therefore, a thorough risk evaluation before the procedure and monitoring during the procedure must be performed. In addition, properly trained staff and emergency equipment should be available. The best approach to sedation in endoscopy is to choose a sedation regimen for the individual patient, tailored according to the clinical risk assessment and the anxiety level of the patient, as well as to the type of planned endoscopic procedure.
Key Points
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Sedation can make endoscopic procedures more comfortable and successful; however, about half of the serious complications in gastrointestinal endoscopy are due to procedural sedation
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Risk estimation for each individual is essential before choosing the best sedation strategy and appropriate monitoring for the patient
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Routine monitoring of patients should include heart rate, blood pressure and oxygen saturation
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Dedicated emergency equipment as well as a properly trained staff must be available in case of cardiorespiratory depression during the procedure and during post-procedure care
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M. Müller and T. Wehrmann are on the speakers bureau for B. Braun Melsungen and Fresenius Medical.
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Müller, M., Wehrmann, T. How best to approach endoscopic sedation?. Nat Rev Gastroenterol Hepatol 8, 481–490 (2011). https://doi.org/10.1038/nrgastro.2011.122
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DOI: https://doi.org/10.1038/nrgastro.2011.122
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