Burtea DE, Dimitriu A, Maloş AE, Săftoiu A. Current role of non-anesthesiologist administered propofol sedation in advanced interventional endoscopy. World J Gastrointest Endosc 2015; 7(10): 981-986 [PMID: 26265991 DOI: 10.4253/wjge.v7.i10.981]
Corresponding Author of This Article
Adrian Săftoiu, MD, PhD, MSc, FASGE, Visiting Clinical Professor, Research Center of Gastroenterology and Hepatology Craiova, University of Medicine and Pharmacy Craiova, 2 Petru Rares str., 200639 Craiova, Romania. adrian.saftoiu@umfcv.ro
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Endosc. Aug 10, 2015; 7(10): 981-986 Published online Aug 10, 2015. doi: 10.4253/wjge.v7.i10.981
Current role of non-anesthesiologist administered propofol sedation in advanced interventional endoscopy
Daniela Elena Burtea, Anca Dimitriu, Anca Elena Maloş, Adrian Săftoiu
Daniela Elena Burtea, Adrian Săftoiu, Research Center of Gastroenterology and Hepatology Craiova, University of Medicine and Pharmacy Craiova, 200639 Craiova, Romania
Daniela Elena Burtea, Endoscopy Department, Clinical County Emergency Hospital Craiova, 200639 Craiova, Romania
Anca Dimitriu, Anca Elena Maloş, Anesthesiology Department, Clinical County Emergency Hospital Craiova, 200639 Craiova, Romania
Adrian Săftoiu, Endoscopy Department, Gastrointestinal Unit, Copenhagen University Hospital Herlev, 2730 Herlev, Denmark
Author contributions: Burtea DE retrieved the references, carefully reviewed the literature and wrote the initial manuscript; Dimitriu A and Maloş AE contributed to the reviewing of the manuscript; Săftoiu A designed the content of the mini-review and wrote parts of the manuscript.
Supported by The Partnership program in priority areas - PN II, implemented with support from National Authority of Scientific Research (ANCS), CNDI - Uefiscdi, Romania, No. 2011-3.1-0252 (Nano-Ablation).
Conflict-of-interest statement: None.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Adrian Săftoiu, MD, PhD, MSc, FASGE, Visiting Clinical Professor, Research Center of Gastroenterology and Hepatology Craiova, University of Medicine and Pharmacy Craiova, 2 Petru Rares str., 200639 Craiova, Romania. adrian.saftoiu@umfcv.ro
Telephone: +40-744-823355 Fax: +40-251-310287
Received: May 7, 2015 Peer-review started: May 9, 2015 First decision: June 3, 2015 Revised: June 21, 2015 Accepted: July 21, 2015 Article in press: July 23, 2015 Published online: August 10, 2015 Processing time: 102 Days and 0.8 Hours
Abstract
Complex and lengthy endoscopic examinations like endoscopic ultrasonography and/or endoscopic retrograde cholangiopancreatography benefit from deep sedation, due to an enhanced quality of examinations, reduced discomfort and anxiety of patients, as well as increased satisfaction for both the patients and medical personnel. Current guidelines support the use of propofol sedation, which has the same rate of adverse effects as traditional sedation with benzodiazepines and/or opioids, but decreases the procedural and recovery time. Non-anesthesiologist administered propofol sedation has become an option in most of the countries, due to limited anesthesiology resources and the increasing evidence from prospective studies and meta-analyses that the procedure is safe with a similar rate of adverse events with traditional sedation. The advantages include a high quality of endoscopic examination, improved satisfaction for patients and doctors, as well as decreased recovery and discharge time. Despite the advantages of non-anesthesiologist administered propofol, there is still a continuous debate related to the successful generalization of the procedures.
Core tip: A large amount of clinical research data demonstrated that propofol provides significant advantages over traditional sedation techniques during advanced endoscopic procedures like endoscopic retrograde cholangiopancreatography and/or endoscopic ultrasonography. Thus, propofol is more effective and safer than the combination of midazolam and meperidine to maintain an adequate level of sedation during advanced endoscopic procedures, with shorter recovery times and increased patient and endoscopist satisfaction. The trend of an increased usage of propofol and generalization of non-anesthesiologist administered propofol sedation in both hospital and private practice settings will certainly increase in the years to come.
