Italian Society of Digestive Endoscopy (SIED) position paper on the non-anaesthesiologist administration of propofol for gastrointestinal endoscopy

Conigliaro, Rita; Fanti, Lorella; Manno, Mauro; Brosolo, P.

doi:10.1016/j.dld.2017.08.038

Cited by 24 publications

(81 citation statements)

References 41 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…38,39 Therefore, 26 documents were included in the nal synthesis, including 19 guidelines [19][20][21][22][24][25][26][27][28][29][30][31][32][33][35][36][37]39,40 and 7 position statements. 41,42,44,[46][47][48][49] Characteristics of Included Documents A summary of the characteristics of the included documents is provided in Supplemental Table 1. Though most documents addressed GI endoscopy procedures in general, four documents speci cally addressed colonoscopy.…”

Section: Resultsmentioning

confidence: 99%

“…Of these, 15 were guidelines [19][20][21][22][25][26][27][28][29][30][31][32][33]35,37 and 7 were position statements. 41,42,44,[46][47][48][49] Only 9 documents 24,26,27,29,31,33,36,40,49 provided a grade or level of evidence in support of their recommendations, making it di cult to assess the evidentiary base for the reported recommendations. When used, recommendation and evidence grading systems varied across documents, making cross-document comparisons challenging.…”

Section: Resultsmentioning

confidence: 99%

“…Nineteen documents (14 guidelines [19][20][21][22]24,27,[29][30][31][32][33][35][36][37] and 5 position statements 41,44,[47][48][49] ) provided recommendations regarding the types of healthcare professionals capable of administering sedation for routine GI endoscopy. These recommendations are summarized in Table 3.…”

Section: Personnel Capable Of Administering Sedationmentioning

confidence: 99%

“…41 Although all three documents recommended that an anesthesia professional be involved in the administration of deep sedation, documents varied in the strength of their recommendations and the suggested personnel -the SGNA recommended that involvement of an anesthesiologist be considered for patients undergoing deep sedation 41 ; the ASGE suggested that anesthesia professionals could include an anesthesiologist, a certi ed registered nurse anesthetist, or an anesthesiology assistant, depending on institutional policies 21 ; and the GESA stated that an anesthesiologist or other appropriately trained and credential medical specialist must be present when deep sedation is used. 20 Recommendations speci c to the administration of propofol were provided in 13 documents 19,20,22,24,27,29,31,33,36,44,[47][48][49] and varied considerably. Documents from the CSGNA, 44 GESA, 20 and British Society of Gastroenterology (BSG) 29 did not support nurse-administered propofol sedation; the GESA 20 and BSG 29 further recommended that propofol be administered by an anesthesiologist or a second, appropriately trained, medical practitioner who is not the endoscopist.…”

Section: Personnel Capable Of Administering Sedationmentioning

confidence: 99%

“…Documents from the CSGNA, 44 GESA, 20 and British Society of Gastroenterology (BSG) 29 did not support nurse-administered propofol sedation; the GESA 20 and BSG 29 further recommended that propofol be administered by an anesthesiologist or a second, appropriately trained, medical practitioner who is not the endoscopist. 20 In contrast, documents from the ESGE, 24 DSRPGSA, 19 ASGE, 49 and Italian Society of Digestive Endoscopy (ISDE) 48 speci cally focused on non-anesthesiologist administered propofol (NAAP) sedation and 5 additional documents made recommendations regarding cases in which NAAP sedation would be appropriate. 22,31,33,36,47 These documents generally stated that NAAP sedation is safe in appropriately selected patients 22,31,33,47,48 and may improve e ciency of the endoscopy unit.…”

Section: Personnel Capable Of Administering Sedationmentioning

confidence: 99%

See 4 more Smart Citations

Sedation Practices for Routine Gastrointestinal Endoscopy: A Systematic Review of Recommendations

Dossa

Megetto

Yakubu

et al. 2020

Preprint

View full text Add to dashboard Cite

Background Sedation is commonly used in gastrointestinal endoscopy; however, considerable variability in sedation practices has been reported. The objective of this review was to identify and synthesize existing recommendations on sedation practices for routine gastrointestinal endoscopy procedures. Methods We systematically reviewed guidelines and position statements identified through a search of PubMed, guidelines databases, and websites of relevant professional associations from January 1, 2005 to May 10, 2019. We included English-language guidelines/position statements with recommendations relating to sedation for adults undergoing routine gastrointestinal endoscopy. Documents with guidance only for complex endoscopic procedures were excluded. We extracted and synthesized recommendations relating to: 1) choice of sedatives, 2) sedation administration, 3) personnel responsible for monitoring sedated patients, 4) skills and training of individuals involved in sedation, and 5) equipment required for monitoring sedated patients. We assessed the quality of included documents using the Appraisal of Guidelines for Research & Evaluation (AGREE) II tool. Results We identified 19 guidelines and 7 position statements meeting inclusion criteria. Documents generally agreed that a single, trained registered nurse can administer moderate sedation, monitor the patient, and assist with brief, interruptible tasks. Documents also agreed on the routine use of pulse oximetry and blood pressure monitoring during endoscopy. However, recommendations relating to the drugs to be used for sedation, the healthcare personnel capable of administering propofol and monitoring patients sedated with propofol, and the need for capnography when monitoring sedated patients varied. Only 9 documents provided a grade or level of evidence in support of their recommendations. Conclusions Recommendations for sedation practices in routine gastrointestinal endoscopy differ across guidelines/position statements and often lack supporting evidence with potential implications for patient safety and procedural efficiency. Registration Number CRD42019141076

show abstract