Year 2018 / Volume 110 / Number 4
Special Article
Endoscopy and sedation: an inseparable binomial for the gastroenterologist

250-252

DOI: 10.17235/reed.2018.5585/2018

Javier Crespo, Álvaro Terán,

Abstract
The development of endoscopy and its increasing demand among the population have led to a growing need for propofol-based sedation techniques. Benefit is indisputable for both patients and endoscopists, but some aspects require considering the “who” and “how” of sedation as related to safety and health care costs. Propofol is first-choice in endoscopy for the European Society of Gastrointestinal Endoscopy because of its fast onset of action and short half-life, and many reports exist on its safety when used by gastroenterologists rather than anesthesiologists. In this issue of REED several originals support the efficiency and safety of propofol even for complex, high-risk, or protracted procedures such as endoscopic retrograde cholangiopancreatography (ERCP) and enteroscopy. Propofol may be safely and effectively administered by a team with specific skills acquired through education and using a specific procedure. However, difficulties arise in real-world clinical practice that preclude such training, which in Spain should be included in the MIR (médico interno residente) specialization program curriculum. The Comisión Nacional de Digestivo (Spanish National Commission on Digestive Diseases), sensitive to this training gap, has included in their latest version of the MIR program (under assessment) four additional competences, with number 145 (training in deep sedation) being most relevant here. In addition, the Spanish Society of Gastrointestinal Endoscopy (SEED) has invested significant efforts in sedation training, with over 50 courses on sedation for endoscopists and nurses. Continuing education and training in this field (for instance, refresher courses on advanced cardiopulmonary resuscitation) should be a goal for all endoscopy units. Because of the diversity found among hospitals, with single or multiple endoscopy rooms, efforts should be made to persuade those in charge of gastroenterology and anesthesiology departments to establish the necessary care circuits in order to guarantee patient safety by developing accurate protocols and promoting consensus among the scientific societies involved (Spanish Society for Digestive Diseases [SEPD], SEED and Spanish Society of Anaesthesiology, Resuscitation and Pain Management [SEDAR]) and their respective national commissions.
Share Button
New comment
Comments
No comments for this article
References
1. Lucendo AJ, González-Huix F, Tenias JM et al. Gastrointestinal Endoscopy Sedation and Monitoring Practices in Spain: A Nationwide Survey in the Year 2014. Endoscopy 2015; 47: 383–90
2. Early DS, Lightdale JR, Vargo JJ et al. Guidelines for sedation and anesthesia in GI endoscopy. Gastrointest Endosc 2018;87(2):327–37
3. Dumonceau JM, Riphaus A, Schreiber F et al. Non-anesthesiologist administration of propofol for gastrointestinal endoscopy: European Society of Gastrointestinal Endoscopy, European Society of Gastroenterology and Endoscopy Nurses and Associates Guideline – Updated June 2015. Endoscopy 2015; 47: 1175–89.
4. Wang D, Chen C, Chen J et al. The use of propofol as a sedative agent in gastrointestinal endoscopy: a meta-analysis. PLoS One. 2013;8(1): e53311. DOI: 10.1371/ journal.pone. 0053311. Epub 2013 Jan 8.
5. Vargo JJ, Niklewski PJ, Williams JL et al. Patient safety during sedation by anesthesia profesionalsduring routine upper endoscopy and colonoscopy: an analysis of 1,38 million procedures. Gastrointest Endosc 2016. DOI: 10.1016/j.gie.2016.02.007
6. Wadhwa V, Issa D, Garg S et al. Similar Risk of Cardiopulmonary Adverse Events Between Propofol and Traditional Anesthesia for Gastrointestinal Endoscopy: A Systematic Review and Meta-analysis. Clin Gastroenterol Hepatol. 2017; 15: 194-206
7. Maestro Antolín et al. COMPLICACIONES CARDIO-RESPIRATORIAS GRAVES DERIVADAS DE LA SEDACIÓN CON PROPOFOL CONTROLADO POR ENDOSCOPISTA EN NUESTRA UNIDAD EN LOS ÚLTIMOS 6 AÑOS. REED 2018.
8. Israel Grilo Bensusan Estudio prospectivo de los factores asociados a una mala tolerancia a la colonoscopia ambulatoria bajo sedación consciente.
9. L Luzón Solanas SEGURIDAD DE LA SEDACIÓN PROFUNDA CON PROPOFOL CONTROLADA POR EL ENDOSCOPISTA EN LA COLANGIOPANCREATOGRAFÍA RETRÓGRADA ENDOSCÓPICA (CPRE). ESTUDIO PROSPECTIVO EN UN HOSPITAL TERCIARIO.
10. Leopoldo López Rosés. VIABILIDAD DE LA ENTEROSCOPIA MONOBALON REALIZADA BAJO SEDACION DIRIGIDA POR ENDOSCOPISTA.
11. López-Muñoz, Cristina. Calidad de la sedación con propofol por personal no anestesiólogo en una unidad de endoscopia digestiva, resultados tras un año de implantación.
12. Julián-Gómez Laura. ENSAYO CLÍNICO COMPARANDO PROPOFOL VERSUS PROPOFOL MAS MIDAZOLAM EN ENDOSCOPIA DIGESTIVA ALTA DIAGNÓSTICA.
13. Igea F, Casellas JA, González-Huix F et al. Clinical practice guidelines of the Spanish Society of Digestive Endoscopy. Endoscopy. 2014; 46: 720-31
Related articles

Letter

Blue rubber bleb nevus syndrome

DOI: 10.17235/reed.2023.9913/2023

Letter

Capsule endoscopy diagnosis of gastrointestinal melanoma

DOI: 10.17235/reed.2023.9803/2023

Letter

Calcifying fibrous tumor and pathological analysis

DOI: 10.17235/reed.2023.9739/2023

Letter

Endoscopic observation of a rare duodenal tumor

DOI: 10.17235/reed.2023.9679/2023

Letter

Endoscopic rescue of a fistulizing biliary plastic stent

DOI: 10.17235/reed.2023.9673/2023

Letter

MALT lymphoma of the colon: an endoscopic challenge

DOI: 10.17235/reed.2023.9595/2023

Letter

Sigmoid volvulus management, only endoscopic devolvulation?

DOI: 10.17235/reed.2023.9488/2023

Letter

Isolated Jejunal Crohn's Disease: a challenging diagnosis

DOI: 10.17235/reed.2022.9423/2022

Letter

New technique for the endoscopic removal of long foreign bodies

DOI: 10.17235/reed.2023.9398/2022

Digestive Diseases Image

Whipple’s disease – A typical endoscopic finding of a rare disease

DOI: 10.17235/reed.2022.9338/2022

Digestive Diseases Image

A case of esophageal histoplasmosis mimicking carcinoma on endoscopy

DOI: 10.17235/reed.2023.9167/2022

Digestive Diseases Image

A rare endoscopic pattern in a patient with gastroesophageal reflux disease

DOI: 10.17235/reed.2022.9124/2022

Digestive Diseases Image

Esophageal tuberculosis

DOI: 10.17235/reed.2022.9108/2022

Digestive Diseases Image

Esophagopleural fistula due to empyema necessitans

DOI: 10.17235/reed.2022.9085/2022

Digestive Diseases Image

Pneumatosis intestinalis: a rare endoscopic feature of colonic ischemia

DOI: 10.17235/reed.2022.8980/2022

Letter

Primary intestinal melanoma?

DOI: 10.17235/reed.2022.8944/2022

Letter

Intestinal amyloidosis: a diagnostic challenge

DOI: 10.17235/reed.2022.8934/2022

Letter

Successful gallstone ileus treatment by endoscopy

DOI: 10.17235/reed.2022.8898/2022

Letter

Digestive tract MALT lymphoma, an unusual location

DOI: 10.17235/reed.2022.8800/2022

Digestive Diseases Image

Esophageal epidermoid metaplasia: an unusual condition

DOI: 10.17235/reed.2022.8708/2022

Digestive Diseases Image

Ileal neuroendocrine tumor as an uncommon cause of obscure gastrointestinal bleeding

DOI: 10.17235/reed.2022.8641/2022

Digestive Diseases Image

A case of duodenal-type follicular lymphoma

DOI: 10.17235/reed.2021.8233/2021

Digestive Diseases Image

Endoscopic resection of a duodenal neuroendocrine tumor

DOI: 10.17235/reed.2021.8232/2021

Digestive Diseases Image

Duodenal-type follicular lymphoma: a silent tumor

DOI: 10.17235/reed.2021.8149/2021

Digestive Diseases Image

Primary or idiopathic intestinal pneumatosis: a rare casual endoscopic finding

DOI: 10.17235/reed.2021.8049/2021

Letter

Bochdalek hernia: use of capsule endoscopy

DOI: 10.17235/reed.2021.7760/2020

Digestive Diseases Image

Endoscopic forceps removal for complicated magnetic beads impaction

DOI: 10.17235/reed.2021.7731/2020

Digestive Diseases Image

Esophageal involvement in a patient with pemphigus vulgaris

DOI: 10.17235/reed.2020.7417/2020

Letter

Basic training in gastrointestinal endoscopy: recording images

DOI: 10.17235/reed.2020.7385/2020

Review

Advanced therapy by device-assisted enteroscopy

DOI: 10.17235/reed.2020.6971/2020

Letter

Luetic gastritis: an uncommon cause of gastritis

DOI: 10.17235/reed.2020.6870/2020

Letter

Gastric ulcer due to mucormycosis in a critical patient

DOI: 10.17235/reed.2020.6636/2019

Letter

Primary gastric choriocarcinoma

DOI: 10.17235/reed.2020.6478/2019

Digestive Diseases Image

Jejunal schwannoma detected by video capsule endoscopy

DOI: 10.17235/reed.2020.6474/2019

Digestive Diseases Image

Capsule endoscopy, a useful tool for the diagnosis of a tapeworm infection

DOI: 10.17235/reed.2019.6346/2019

Editorial

Endoscopy units – Statu quo

DOI: 10.17235/reed.2019.6347/2019

Letter

Endoscopically diagnosed systemic mastocytosis

DOI: 10.17235/reed.2019.6246/2019

Digestive Diseases Image

A rare heterotopic gastric mucosa appearing between the muscularis mucosae and submucosa

DOI: 10.17235/reed.2019.6134/2018

Special Article

Quality indicators in gastroscopy. Gastroscopy procedure

DOI: 10.17235/reed.2019.6023/2018

Letter

Endoscopic management of Boerhaave’s syndrome

DOI: 10.17235/reed.2019.6013/2018

Digestive Diseases Image

Intraductal papillary mucinous neoplasm of the main duct in a patient with pancreas divisum

DOI: 10.17235/reed.2019.5959/2018

Letter

Use of patency capsule in daily practice

DOI: 10.17235/reed.2019.5952/2018

Letter

Symptomatic exfoliative esophagitis induced by dabigatran

DOI: 10.17235/reed.2018.5747/2018

Special Article

The current situation of digestive endoscopy units in the Valencian Community

DOI: 10.17235/reed.2019.5676/2018

Letter to the Editor

Me, the intruder: revisited and rethought

DOI: 10.17235/reed.2018.5575/2018

Digestive Diseases Image

Dysphagia and hematemesis caused by an intramural esophageal dissection

DOI: 10.17235/reed.2018.5471/2018

Letter to the Editor

GETTEMO position statement on bariatric endoscopic techniques as a voluntary medicine

DOI: 10.17235/reed.2017.5144/2017

Letter to the Editor

Propofol sedation Quality and safety. Failure mode and effects analysis.

DOI: 10.17235/reed.2017.4976/2017

Digestive Diseases Image

Metastasis of dermatofibrosarcoma diagnosed by capsule endoscopy

DOI: 10.17235/reed.2018.4900/2017

Letter to the Editor

Enough discussions about who should use propofol in gastrointestinal endoscopy

DOI: 10.17235/reed.2017.4901/2017

Letter to the Editor

Symptomatic retention of the Agile® patency capsule

DOI: 10.17235/reed.2017.4691/2016

Special Article

Patient safety under deep sedation for digestive endoscopic procedures

DOI: 10.17235/reed.2016.4572/2016

Letter to the Editor

Ball valve syndrome caused by a giant gastric Vanek’s tumor

DOI: 10.17235/reed.2017.4526/2016

Original

Multicenter study on the safety of bariatric endoscopy

DOI: 10.17235/reed.2017.4499/2016

Letter to the Editor

Endoscopic removal of a hashish packet

DOI: 10.17235/reed.2017.4504/2016

Letter to the Editor

Whipple’s disease under the vision of capsule endoscopy

DOI: 10.17235/reed.2016.4362/2016

Letter to the Editor

Asymptomatic bronchial aspiration of capsule endoscope: a significant complication

DOI: 10.17235/reed.2016.4363/2016

Letter to the Editor

Author´s reply: About human taeniasis and Taenia saginata diagnosis by endoscopy

DOI: 10.17235/reed.2016.4339/2016

Letter to the Editor

About human taeniasis and Taenia saginata diagnosis by endoscopy

DOI: 10.17235/reed.2016.4297/2016

Letter to the Editor

Transanal submucosal endoscopic resection (TASER) by TEO system®

DOI: 10.17235/reed.2016.4154/2015

Case Report

Atypical diagnosis diagnosis by endoscopic capsule: Whipple´s disease

DOI: 10.17235/reed.2015.3718/2015

Citation tools
Crespo J, Terán Á. Endoscopy and sedation: an inseparable binomial for the gastroenterologist . 5585/2018


Download to a citation manager

Download the citation for this article by clicking on one of the following citation managers:

Metrics
This article has received 1562 visits.
This article has been downloaded 654 times.

Statistics from Dimensions


Statistics from Plum Analytics

Publication history

Received: 08/03/2018

Accepted: 08/03/2018

Online First: 26/03/2018

Published: 02/04/2018

Article Online First time: 18 days

Article editing time: 25 days


Share
This article has been rated by 1 readers.
Reader rating:
Valora este artículo:




Asociación Española de Ecografía Digestiva Sociedad Española de Endoscopia Digestiva Sociedad Española de Patología Digestiva
The Spanish Journal of Gastroenterology is the official organ of the Sociedad Española de Patología Digestiva, the Sociedad Española de Endoscopia Digestiva and the Asociación Española de Ecografía Digestiva
Cookie policy Privacy Policy Legal Notice © Copyright 2024 y Creative Commons. The Spanish Journal of Gastroenterology