Endoscopy 2019; 51(04): S189
DOI: 10.1055/s-0039-1681729
ESGE Days 2019 ePoster podium presentations
Saturday, April 6, 2019 13:30 – 14:00: Sedation ePoster Podium 8
Georg Thieme Verlag KG Stuttgart · New York

SAFETY AND EFFICACY OF NON-ANESTHESIOLOGIST ADMINISTERED SEDATION (NAS) IN GASTROINTESTINAL ENDOSCOPY: A PROSPECTIVE, MONOCENTRIC STUDY OF 9380 PROCEDURES

S Deiana
1   Digestive Endoscopy Modena Northern Area, Carpi and Mirandola Hospital, AUSL Modena, Carpi, Italy
,
T Gabbani
1   Digestive Endoscopy Modena Northern Area, Carpi and Mirandola Hospital, AUSL Modena, Carpi, Italy
,
P Soriani
1   Digestive Endoscopy Modena Northern Area, Carpi and Mirandola Hospital, AUSL Modena, Carpi, Italy
,
V Mirante
1   Digestive Endoscopy Modena Northern Area, Carpi and Mirandola Hospital, AUSL Modena, Carpi, Italy
,
M Manno
1   Digestive Endoscopy Modena Northern Area, Carpi and Mirandola Hospital, AUSL Modena, Carpi, Italy
› Author Affiliations
Further Information

Publication History

Publication Date:
18 March 2019 (online)

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Aims:

Sedation is an integral part of gastrointestinal endoscopy, but the best sedation strategy is still a matter of debate. Non-anesthesiologist (NAS) propofol-based-sedation (PBS) remains controversial because of concerns about safety. The aim of the study was to evaluate safety and efficacy of NAS, comparing traditional sedation with PBS.

Methods:

We prospectively collected data of endoscopic exams consecutively performed at our Endoscopy Unit during 17 months. Procedures were classified into two groups: traditional sedation with midazolam and/or fentanyl (group1) and PBS (group2). All gastroenterologists and nurses were trained accordingly to the ESGE position paper. Safety was evaluated in terms of adverse events requiring medical interventions, while efficacy in terms of cecal intubation. Continuous data are expressed as A p value less than 0.05 was considered statistically significant.

Results:

Among 10624 patients, 9380 (mean age 61.2 ± 14.7 years) underwent endoscopies in NAS: 62.3% (5845) were colonoscopy, 33.7% (3157) esophago-gastro-duodenoscopy, 1.4% (133) echoendoscopy and 0.05% (5) were push-enteroscopy. The majority of procedures were performed in outpatient setting (8176, 87.2%) and in most cases they were diagnostic procedures (8780, 93.6%). Group 1 was composed by 1999 patients (21.3%), while group 2 by 7381 patients (78.7%). Twenty-one (0.22%) minor adverse events (17 transitory hypotension/bradichardia and 4 transitory oxygen desaturation) were registered, 3 in group 1 and 18 in group 2. No major complications (i.e. hospitalization, tracheal intubation or death) occurred. No differences between groups in terms of rate of adverse events were registered (0,15% vs. 0,24%; pNS). Cecal intubation rate during colonoscopy was higher in PBS group (99.2% in group1 and 100% in group2; p < 0.05), while 9 colonoscopy in group1 was stopped for intolerance.

Conclusions:

The study adds new favourable data on the safety of NAS with PBS in digestive endoscopy with specifically trained staff. Moreover, propofol sedation increases the endoscopic examination effectiveness, avoiding failure for patients intolerance.