The use of an evidence-based sedation protocol for endoscopic procedures improves the quality of practice and reduces the incidence of sedation-related adverse events, according to an AGA Institute Review of Endoscopic Sedation published in the August issue of Gastroenterology, the official journal of the American Gastroenterological Association (AGA) Institute.
"The AGA Institute supports the administration of sedation by gastroenterologists performing endoscopic procedures on average risk patients, provided that they have proper training and experience, stated Nicholas LaRusso, MD, AGAF, President of the AGA Institute. "Patients should feel comfortable undergoing an endoscopic procedure, including the administration of intravenous sedation, by a gastroenterologist who is trained and licensed."
The use of sedation during endoscopic procedures, including colonoscopies and upper endoscopies, is considered a medical necessity by gastroenterologists, with more than 98 percent utilizing sedation during these procedures. By reducing a patient's anxiety and discomfort during the procedure, gastroenterologists are able to better ensure that they are performing a thorough exam while minimizing the patient's risk of injury and improving their tolerability.
"Due to the widespread use of sedation during endoscopy procedures, it is of great importance that gastroenterologists implement sedation protocols in their practices to improve the quality of practice and minimize the risk of sedation-related adverse events," according to Lawrence Cohen, MD, AGAF, associate clinical professor at The Mount Sinai Hospital, New York, and co-author of the paper.
The review was based on an evidence-based analysis of the literature, whenever possible. In areas in which evidence from controlled studies was absent, data from case series, retrospective database studies and expert opinions in endoscopy and anesthesia were used. The AGA Institute Review generated 16 summary statements and recommendations on the use of sedation in endoscopies: