Published online Aug 10, 2015. doi: 10.4253/wjge.v7.i10.981
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
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.