Reply to J. S. Baudet et al.

On behalf of all my co-authors I would like to express my thanks for the appreciation and overall positive feedback given by Dr. Baudet, Dr. Sánchez del Río, and Dr. Alarcón-Fernandez. I absolutely agree that patient safety and perceived quality (i. e. patient satisfaction) is essential in the assessment of overall quality of upper (and also lower) gastrointestinal endoscopy. It must, however, be stressed that there is a considerable body of data showing improved patient acceptance if propofol sedation is used. This is also highlighted by the fact that updated guidelines on sedation in endoscopy support the increasing importance of propofol sedation [1] [2]. Nevertheless, the purpose of our study was to provide evidence on the subjective feeling that propofol sedation is also associated with improved examination conditions from an examiner’s point of view (apart from its patient-related benefits). Because data on the acceptability of this type of sedation from the examiner’s standpoint have been sparse, we aimed to fill this gap.

One should keep in mind that the results as presented in our study represent only a small fraction of the effect of medical practice on the overall quality of healthcare. Therefore, once again, I absolutely agree with our Spanish colleagues that patient satisfaction is an important aspect that we should all keep in mind. However, what is patient satisfaction worth if endoscopy is performed inaccurately? The bottom line is that we should use propofol in all patients requiring sedation.

Competing interests: None

References

• 1 Cohen L B, Delegge M H, Aisenberg J . AGA Institute review of endoscopic sedation.  Gastroenterology. 2007;  133 675-701
• 2 Schreiber F, . The Working Group on Endoscopy, . Austrian Society of Gastroenterology and Hepatology (ÖGGH): guidelines on sedation and monitoring during gastrointestinal endoscopy.  Endoscopy. 2007;  39 259-262