Korean J Gastroenterol.  2022 Apr;79(4):141-155. 10.4166/kjg.2021.157.

2021 Korean Society of Gastrointestinal Endoscopy Clinical Practice Guidelines for Endoscopic Sedation

Affiliations
  • 1Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
  • 2Department of Internal Medicine, Incheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
  • 3Department of Internal Medicine, Dongguk University Ilsan Hospital, Goyang, Korea
  • 4Department of Internal Medicine, Ewha Womans University Seoul Hospital, Seoul, Korea
  • 5Department of Internal Medicine, Kangwon National University Hospital, Kangwon National University School of Medicine, Chuncheon, Korea
  • 6Department of Internal Medicine, Seoul Medical Center, Seoul, Korea
  • 7Department of Internal Medicine, Jeonbuk National University Hospital, Jeonju, Korea
  • 8Department of Internal Medicine, Korea University Anam Hospital, Seoul, Korea
  • 9Department of Pediatrics, Seoul Metropolitan Children’s Hospital, Seoul, Korea
  • 10Department of Internal Medicine, Wonkwang University Hospital, Iksan, Korea
  • 11Department of Internal Medicine, Gachon University, Gil Medical Center, Incheon, Korea
  • 12Department of Internal Medicine, Uijungbu St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
  • 13Yonsei Wonju Medical Library, Yonsei University Wonju College of Medicine, Wonju, Korea
  • 14Division of Healthcare Technology Assessment Research, National Evidence-based Healthcare Collaborating Agency, Seoul, Korea
  • 15Department of Urology, Yonsei University Wonju College of Medicine/Center of Evidence Based Medicine Institute of Convergence Science, Wonju, Korea
  • 16Division of Gastroenterology, Department of Internal Medicine, Cha University Gangnam Medical Center, Seoul, Korea

Abstract

Sedation can resolve anxiety and fear in patients undergoing endoscopy. The use of sedatives has increased in Korea. Appropriate sedation is a state in which the patient feels subjectively comfortable while maintaining the airway reflex for stable spontaneous breathing. The patient should maintain a state of consciousness to the extent that he or she can cooperate with the needs of the medical staff. Despite its benefits, endoscopic sedation has been associated with cardiopulmonary complications. Cardiopulmonary complications are usually temporary. Most patients recover without sequelae. However, they may progress to serious complications, such as cardiovascular collapse. Therefore, it is essential to screen high-risk patients before sedation and reduce complications by meticulous monitoring. Additionally, physicians should be familiar with the management of emergencies. The first Korean clinical practice guideline for endoscopic sedation was developed based on previous worldwide guidelines for endoscopic sedation using an adaptation process. The guideline consists of nine recommendations based on a critical review of currently available data and expert consensus when the guideline was drafted. These guidelines should provide clinicians, nurses, medical school students, and policy makers with information on how to perform endoscopic sedation with minimal risk.

Keyword

Endoscopy; Guideline; Sedation

Figure

  • Fig. 1 PRISMA flow chart for selecting reference clinical practice guidelines. KoMCI, Korea Medical Citation Index; NICE, National Institute of Health and Care Excellence; WHO, World Health Organization.

  • Fig. 2 Mallampati classification of airways. The patient is assessed while sitting up with the mouth opened wide and tongue protruded as much as possible.


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