Year 2018 / Volume 110 / Number 4
Original
Quality of sedation with propofol administered by non-anesthetists in a digestive endoscopy unit: the results of a one year experience

231-236

DOI: 10.17235/reed.2018.5283/2017

Cristina López Muñoz, Andrés Sánchez Yagüe, Jose Carlos Canca Sánchez, José Antonio Reinaldo-Lapuerta, Ana Belén Moya Suárez,

Abstract
Introduction: research has shown that an endoscopist-nurse clinical team can perform sedation with propofol effectively, safely and efficiently. To do so, it is essential to provide specific and appropriate training in the necessary skills. The main aim of the present study was to evaluate the quality of the sedation procedure administered by non-anesthetists in a digestive endoscopy unit, one year after its introduction. Methods: a prospective cohort study was performed in patients given propofol sedation by non-anesthetists. Subsequently, a random sample of clinical records was selected in order to evaluate the adherence of professionals to the quality criteria and to assess the rate of adverse events related to sedation. Results: a total of 595 procedures were performed under propofol sedation during the study period. The rate of adverse events was 2.4% (n = 507), mainly involving hypotension and hypoxemia. Adherence to the sedation procedure was above 80% for most of the applicable criteria, although it was lower for the completion of ASA risk evaluation. Conclusions: the results of the study suggest that propofol can be administered safely and effectively by a qualified endoscopist-nurse team, in patients with an ASA I-II risk. Audits of adherence by medical staff to the recommended procedure facilitate the identification of areas for improvement; further work is needed on the aspects that have not yet been consolidated.
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References
1. Goudra BG, Singh PM, Gouda G, Borle A, Gouda D, Dravida A, et al. Safety of Non-anesthesia Provider-Administered Propofol (NAAP) Sedation in Advanced Gastrointestinal Endoscopic Procedures: Comparative Meta-Analysis of Pooled Results. Dig Dis Sci. septiembre de 2015;60(9):2612-27.
2. Gouda B, Gouda G, Borle A, Singh A, Sinha A, Singh PM. Safety of non-anesthesia provider administered propofol sedation in non-advanced gastrointestinal endoscopic procedures: A meta-analysis. Saudi J Gastroenterol Off J Saudi Gastroenterol Assoc. junio de 2017;23(3):133-43.
3. Lee JK, Jang DK, Kim WH, Kim JW, Jang BI. [Safety of Non-anesthesiologist Administration of Propofol for Gastrointestinal Endoscopy]. Korean J Gastroenterol Taehan Sohwagi Hakhoe Chi. 25 de enero de 2017;69(1):55-8.
4. Vargo JJ, Niklewski PJ, Williams JL, Martin JF, Faigel DO. Patient safety during sedation by anesthesia professionals during routine upper endoscopy and colonoscopy: an analysis of 1.38 million procedures. Gastrointest Endosc. enero de 2017;85(1):101-8.
5. es_especial.pdf [Internet]. [citado 24 de septiembre de 2017]. Disponible en: http://scielo.isciii.es/pdf/diges/v106n3/es_especial.pdf
6. Pérez-Cuadrado Robles E, González Ramírez A, Lancho Seco Á, Martí Marqués E, Dacal Rivas A, Castro Ortiz E, et al. Safety and risk factors for difficult endoscopist-directed ERCP sedation in daily practice: a hospital-based case-control study. Rev Espanola Enfermedades Dig Organo Of Soc Espanola Patol Dig. mayo de 2016;108(5):240-5.
7. Dumonceau J-M, Riphaus A, Beilenhoff U, Vilmann P, Hornslet P, Aparicio J, et al. European Curriculum for Sedation Training in Gastrointestinal Endoscopy: Position Statement of the European Society of Gastrointestinal Endoscopy (ESGE) and European Society of Gastroenterology and Endoscopy Nurses and Associates (ESGENA). Endoscopy. 23 de mayo de 2013;45(06):496-504.
8. Guia_Sedacion_en_endoscopia_digestiva_SEED.pdf [Internet]. [citado 24 de septiembre de 2017]. Disponible en: http://www.wseed.org/images/site/pdf/Guia_Sedacion_en_endoscopia_digestiva_SEED.pdf
9. Vargo JJ, DeLegge MH, Feld AD, Gerstenberger PD, Kwo PY, Lightdale JR, et al. Multisociety Sedation Curriculum for Gastrointestinal Endoscopy. Gastroenterology. julio de 2012;143(1):e18-41.
10. SEED | SOCIEDAD ESPAÑOLA DE ENDOSCOPIA DIGESTIVA - Cursos de Sedación 2017 [Internet]. [citado 24 de septiembre de 2017]. Disponible en: http://www.wseed.org/index.php/cursos-y-congresos/cursos-de-la-seed/cursos-de-sedacion/curso-de-sedacion-2017
11. Moorthy K, Munz Y, Sarker SK, Darzi A. Objective assessment of technical skills in surgery. BMJ. 1 de noviembre de 2003;327(7422):1032-7.
12. Dumonceau J-M, Riphaus A, Schreiber F, Vilmann P, Beilenhoff U, Aparicio JR, 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. diciembre de 2015;47(12):1175-89.
13. Riphaus A, Wehrmann T, Weber B, Arnold J, Beilenhoff U, Bitter H, et al. S3-Leitlinie „Sedierung in der gastrointestinalen Endoskopie” 2008 (AWMF-Register-Nr. 021 / 014). Z Für Gastroenterol. noviembre de 2008;46(11):1298-330.
14. Da B, Buxbaum J. Training and Competency in Sedation Practice in Gastrointestinal Endoscopy. Gastrointest Endosc Clin N Am. julio de 2016;26(3):443-62.
15. consenso_sedacion_endoscopia_aeg.pdf [Internet]. [citado 24 de septiembre de 2017]. Disponible en: http://www.aegastro.es/sites/default/files/archivos/MBE-CC/consenso_sedacion_endoscopia_aeg.pdf
16. Waring JP, Baron TH, Hirota WK, Goldstein JL, Jacobson BC, Leighton JA, et al. Guidelines for conscious sedation and monitoring during gastrointestinal endoscopy. Gastrointest Endosc. septiembre de 2003;58(3):317-22.
17. Amornyotin S. Sedation and monitoring for gastrointestinal endoscopy. World J Gastrointest Endosc. 16 de febrero de 2013;5(2):47-55.
18. consenso_sedacion_endoscopia_aeg.pdf [Internet]. [citado 24 de septiembre de 2017]. Disponible en: http://www.aegastro.es/sites/default/files/archivos/MBE-CC/consenso_sedacion_endoscopia_aeg.pdf
19. listado_verificacion_endoscopias_costa_sol.pdf [Internet]. [citado 24 de septiembre de 2017]. Disponible en: http://www.juntadeandalucia.es/agenciadecalidadsanitaria/observatorioseguridadpaciente/gestor/sites/PortalObservatorio/cirugiasegura/documentos/listado_verificacion_endoscopias_costa_sol.pdf
20. NAAP: Sedación profunda con propofol para endoscopia digestiva administrada por no anestesiólogos. Posición del endoscopista en el 2011 [Internet]. [citado 27 de septiembre de 2017]. Disponible en: https://www.researchgate.net/publication/282727301_NAAP_Sedacion_profunda_con_propofol_para_endoscopia_digestiva_administrada_por_no_anestesiologos_Posicion_del_endoscopista_en_el_2011
21. Vargo JJ, Zuccaro G, Dumot JA, Shermock KM, Morrow JB, Conwell DL, et al. Gastroenterologist-administered propofol versus meperidine and midazolam for advanced upper endoscopy: a prospective, randomized trial. Gastroenterology. julio de 2002;123(1):8-16.
22. McQuaid KR, Laine L. A systematic review and meta-analysis of randomized, controlled trials of moderate sedation for routine endoscopic procedures. Gastrointest Endosc. mayo de 2008;67(6):910-23.
23. Levitzky BE, Lopez R, Dumot JA, Vargo JJ. Moderate sedation for elective upper endoscopy with balanced propofol versus fentanyl and midazolam alone: a randomized clinical trial. Endoscopy. enero de 2012;44(1):13-20.
24. Dewitt J, McGreevy K, Sherman S, Imperiale TF. Nurse-administered propofol sedation compared with midazolam and meperidine for EUS: a prospective, randomized trial. Gastrointest Endosc. septiembre de 2008;68(3):499-509.
25. Lera dos Santos ME, Maluf-Filho F, Chaves DM, Matuguma SE, Ide E, Luz G de O, et al. Deep sedation during gastrointestinal endoscopy: propofol-fentanyl and midazolam-fentanyl regimens. World J Gastroenterol. 14 de junio de 2013;19(22):3439-46.
26. Sharma VK, Nguyen CC, Crowell MD, Lieberman DA, de Garmo P, Fleischer DE. A national study of cardiopulmonary unplanned events after GI endoscopy. Gastrointest Endosc. julio de 2007;66(1):27-34.
27. Cotton PB, Eisen GM, Aabakken L, Baron TH, Hutter MM, Jacobson BC, et al. A lexicon for endoscopic adverse events: report of an ASGE workshop. Gastrointest Endosc. marzo de 2010;71(3):446-54.
28. Yusoff IF, Raymond G, Sahai AV. Endoscopist administered propofol for upper-GI EUS is safe and effective: a prospective study in 500 patients. Gastrointest Endosc. septiembre de 2004;60(3):356-60.
29. Zakeri N, Coda S, Webster S, Howson W, Thillainayagam AV. Risk factors for endoscopic sedation reversal events: a five-year retrospective study. Frontline Gastroenterol. octubre de 2015;6(4):270-7.
30. Heuss LT, Schnieper P, Drewe J, Pflimlin E, Beglinger C. Safety of propofol for conscious sedation during endoscopic procedures in high-risk patients-a prospective, controlled study. Am J Gastroenterol. agosto de 2003;98(8):1751-7.
31. American Association for Study of Liver Diseases, American College of Gastroenterology, American Gastroenterological Association Institute, American Society for Gastrointestinal Endoscopy, Society for Gastroenterology Nurses and Associates, Vargo JJ, et al. Multisociety sedation curriculum for gastrointestinal endoscopy. Gastrointest Endosc. julio de 2012;76(1):e1-25.
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López Muñoz C, Sánchez Yagüe A, Canca Sánchez J, Reinaldo-Lapuerta J, Moya Suárez A. Quality of sedation with propofol administered by non-anesthetists in a digestive endoscopy unit: the results of a one year experience. 5283/2017


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Publication history

Received: 29/09/2017

Accepted: 15/01/2018

Online First: 21/02/2018

Published: 02/04/2018

Article revision time: 98 days

Article Online First time: 145 days

Article editing time: 185 days


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