Patient safety during sedation by anesthesia professionals during routine upper endoscopy and colonoscopy: an analysis of 1.38 million procedures

Abstract

Within the confines of the SAE definitions used, use of anesthesia professionals does not appear to bring a safety benefit to patients receiving colonoscopy and is associated with an increased SAE risk for ASA I, II, and III patients undergoing EGD.

Optimal procedural sequence for same‐day bidirectional endoscopy with moderate sedation: A prospective randomized study

“…However, the use of anesthesia service does not guarantee a safety benefit to patients. In fact, the overall risk of complications after colonoscopy is higher when patients receive anesthesia services related to those who receive non‐anesthesia sedation . In a prospective cohort study, Wernli et al .…”

“…In fact, the overall risk of complications after colonoscopy is higher when patients receive anesthesia services related to those who receive non-anesthesia sedation. [23][24][25] In a prospective cohort study, Wernli et al found that the use of anesthesia service was associated with a 13% increase in the risk of any complication within 30 days after colonoscopy (95% confidence interval [CI], 1.12-1.14) and was associated specifically with an increased risk of perforation (odds ratio [OR], 1.07; 95% CI, 1.00-1.15), hemorrhage (OR, 1.28; 95% CI, 1.27-1.30), abdominal pain (OR, 1.07; 95% CI, 1.05-1.08), complications secondary to anesthesia (OR, 1.15; 95% CI, 1.05-1.28), and stroke (OR, 1.04; 95% CI, 1.00-1.08). 24 Additionally, the use of anesthesia service was found to be associated with a higher risk of serious adverse events for American Society of Anesthesiology I, II, and III subjects undergoing EGD than those who received endoscopist-directed sedation.…”

Second‐look endoscopy‐guided therapy under sedation prevents early rebleeding after variceal ligation for acute variceal bleeding

“…The sedation procedure for SLE is summarized in the Supplementary Data S4. Any SLE‐associated adverse events (AEs) were evaluated (Supplementary Data S5) . During the SLE immediate endoscopic therapy was performed to control bleeding when AVB occurred.…”

Patient safety under deep sedation for digestive endoscopic procedures

“…González-Huix (18) The crucial fact underlying this reflection by González-Huix (18), ill-informed in our view, is that Vargo (17) compared morbidity in mainly mild-moderate endoscopist-led sedation versus anesthesiologist-administered deep sedation with propofol and general anesthesia. Both unfortunately and inconceivably, González-Huix made the serious statistical error of granting validity to a comparison between sharply different, hence incomparable cohorts in terms of variables.…”

“…The technique's safety when administered by non-anesthesiologists has traditionally raised controversy, usually disguised as scientificism when the real issue is mainly financial in nature, often covered up by dubious debates on the financial sustainability of the health system (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20).…”