Guidelines for Conscious Sedation and Monitoring During Gastrointestinal Endoscopy

Waring, J. Patrick; Baron, Todd H.; Hirota, William K.; Goldstein, Jay L.; Jacobson, Brian C.; Leighton, Jonathan A.; Mallery, J. Shawn; Faigel, Douglas O.

doi:10.1067/s0016-5107(03)00001-4

Cited by 299 publications

(190 citation statements)

References 37 publications

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“…Questions relating to procedure assessment should be included on the board examination and should reflect a general knowledge of this content (70)(71)(72)(73)(74)(75)(76)(77)(78)(79)(80)(81)(82)(83)(84)(85).…”

Section: Assessment Of Competencymentioning

confidence: 99%

Multisociety Sedation Curriculum for Gastrointestinal Endoscopy

Vargo¹,

DeLegge²,

Feld³

et al. 2012

Am J Gastroenterol

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Section: Assessment Of Competencymentioning

confidence: 99%

Multisociety Sedation Curriculum for Gastrointestinal Endoscopy

Vargo¹,

DeLegge²,

Feld³

et al. 2012

Am J Gastroenterol

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“…Use of conscious sedation reduces hospitalization time, speeds recovery, and improves overall patient comfort [1]. Commonly, a moderate level of sedation is achieved by administering narcotics with or without benzodiazepines with the goals of relaxation, raising the pain threshold, and partial amnesia.…”

Section: Introductionmentioning

confidence: 99%

“…Despite the widespread use of conscious sedation in a variety of fields including gastrointestinal endoscopy [1], dentistry [3], emergency medicine [4], and gynecology [5][6][7], many questions concerning the safety of conscious sedation remain unanswered. In combination, opioids and benzodiazepines have the potential for serious complications including respiratory depression and aspiration of gastrointestinal contents [8,9].…”

Section: Introductionmentioning

confidence: 99%

“…However, these risks must be considered within the context of the great comfort and pain relief these medications provide to patients [10,11]. Although the efficacy of conscious sedation for pain management as compared to local and general anesthesia in an outpatient surgical setting has been investigated [1,6,7,10,11], detailed information exploring its relative safety is lacking. Information about the relative importance of a patient having nothing by mouth is unknown.…”

Section: Introductionmentioning

confidence: 99%

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Low-dose fentanyl and midazolam in outpatient surgical abortion up to 18 weeks of gestation

Wilson¹,

Chen²,

Creinin³

2009

Contraception

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Background: We investigated the safety of a conscious sedation protocol using intravenous fentanyl and midazolam by direct venous injection in women who underwent outpatient surgical abortion up to 18 weeks of gestation. Study Design: This retrospective cohort study evaluated 1433 abortion procedures performed on women who received intravenous conscious sedation between April 1, 2001, and December 31, 2006. Women were allowed oral intake before the procedure. De-identified data were abstracted from charts using a standardized extraction form. Primary outcomes evaluated were need for reversal agents, need to obtain emergency intravenous access, pulmonary aspiration, need for oxygen supplementation and hospitalization for any reason. Results: Of the 1433 procedures, 410 women received sedation with continuous intravenous access, and 1023 women received sedation by direct venous injection. More than 95% of women received fentanyl 100 mcg combined with 1-2 mg of midazolam. We identified four (0.3%) instances of adverse events, none of which occurred as a result of oversedation. No women experienced oral content aspiration. Conclusions: Intravenous conscious sedation with fentanyl and midazolam is safe for outpatient surgical abortion in women without cardiovascular compromise up to 18 weeks of gestation. The risk of aspiration or oversedation requiring reversal agents is rare and does not warrant universal direct venous access or restriction of oral intake.

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“…Although some endoscopic procedures such as routine diagnostic upper gastrointestinal endoscopy can be carried out without sedation, many of the other endoscopic procedures are unpleasant and sedation as an adjunct to good pain relief and sympathetic patient management can improve both patient tolerance and acceptance and increase the technical success of the procedure [1]. The fact that the procedure can be performed without systemic medication increases the pressure to use sedation safely.…”

Section: Introductionmentioning

confidence: 99%