Clin Endosc.  2016 Jan;49(1):47-55. 10.5946/ce.2016.49.1.47.

Considerable Variability of Procedural Sedation and Analgesia Practices for Gastrointestinal Endoscopic Procedures in Europe

• Vaessen HH
• Knape JT

• KMID: 2166549
• DOI: http://doi.org/10.5946/ce.2016.49.1.47

Abstract

BACKGROUND/AIMS
The use of moderate to deep sedation for gastrointestinal endoscopic procedures has increased in Europe considerably. Because this level of sedation is a risky medical procedure, a number of international guidelines have been developed. This survey aims to review if, and if so which, quality aspects have been included in new sedation practices when compared to traditional uncontrolled sedation practices.
METHODS
A questionnaire was sent to the National Associations of Nurse Anesthetists in Europe and the National Delegates of the European Section and Board of Anaesthesiology from January 2012 to August 2012.
RESULTS
Huge variation in practices for moderate to deep sedation were identified between and within European countries in terms of safety, type of practitioners, responsibilities, monitoring, informed consent, patient satisfaction, complication registration, and training requirements. Seventy-five percent of respondents were not familiar with international sedation guidelines. Safe sedation practices (mainly propofol-based moderate to deep sedation) are rapidly gaining popularity.
CONCLUSIONS
The risky medical procedure of moderate to deep sedation has become common practice for gastrointestinal endoscopy. Safe sedation practices requiring adequate selection of patients, adequate monitoring, training of sedation practitioners, and adequate after-care, are gaining attention in a field that is in transition from uncontrolled sedation care to controlled sedation care.

Keyword

Moderate to deep sedation; Endoscopy, gastrointestinal; Guideline; Patient safety

MeSH Terms

Analgesia*
Deep Sedation
Endoscopy, Gastrointestinal
Europe*
Humans
Informed Consent
Nurse Anesthetists
Patient Safety
Patient Satisfaction
Surveys and Questionnaires

Figure

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  Fig. 1. Skills training program.

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