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2016 ; 4
(5
): E564-71
Nephropedia Template TP
gab.com Text
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English Wikipedia
Clinical analysis of moderate-to-deep-sedation by nonmedical sedation
practitioners in 597 patients undergoing gastrointestinal endoscopy: a
retrospective study
#MMPMID27227116
Vaessen H
; Bruens E
; Knape J
Endosc Int Open
2016[May]; 4
(5
): E564-71
PMID27227116
show ga
BACKGROUND AND STUDY AIM: The purpose of this study was to evaluate whether
moderate-to-deep sedation with propofol and alfentanil can be administered safely
by nonmedical sedation practitioners, and the outcomes of this practice in the
Netherlands. We retrospectively analyzed the occurrence of sedation-related
complications in patients undergoing gastrointestinal endoscopic procedures.
PATIENTS AND METHODS: In this study, 597 adult patients consecutively underwent
upper gastrointestinal endoscopic procedures. The health status of the patients
was screened according to a standardized protocol, and the patients were sedated
by trained nonmedical sedation practitioners. Their vital signs were continuously
monitored and recorded. All patients received oxygen, and the depth of sedation
was continuously assessed and recorded. Mild and severe complications were
recorded and analyzed. RESULTS: All patients recovered uneventfully, and no
mortality occurred. Overall, of the 597 sedated patients, 85 had mild and 4 had
severe complications. Hypoxemia and upper airway obstruction, which were easily
managed by trained nonmedical sedation practitioners, were the most common
events. Hypotension was rare. No signs or symptoms suggestive of aspiration were
reported. CONCLUSION: Moderate-to-deep sedation has been and continues to be a
risky medical procedure. Serious complications of propofol/opioid-based sedation,
especially respiratory and cardiovascular adverse events, may occur. These
complications need to be recognized rapidly and appropriately managed. Our study
shows that well-trained nonmedical sedation practitioners can be entrusted to
take responsibility for the safe administration of moderate-to-deep sedation.