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Chapter 15 - Sedation in the endoscopy suite

Published online by Cambridge University Press:  05 March 2012

Richard D. Urman
Affiliation:
Brigham and Women's Hospital/Harvard Medical School
Alan D. Kaye
Affiliation:
LSU School of Medicine, New Orleans
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Summary

An integral part of the practice of gastrointestinal endoscopy is adequate sedation and analgesia. The choice of the appropriate sedation modality is always a balance between optimizing the benefits of sedation and minimizing the potential risks. The American Society of Anesthesiologists (ASA) agrees that appropriate pre-procedure evaluation increases the likelihood of satisfactory sedation and decreases the likelihood of adverse outcomes. A vast majority of endoscopic procedures are diagnostic in nature and performed on relatively healthy patients with an ASA status of 1 or 2. Diagnostic and therapeutic endoscopic interventions include esophagogastroduodenoscopy (EGD), proctoscopy/sigmoidoscopy/colonoscopy, and endoscopic retrograde cholangiopancreatography (ERCP). Sedation for gastrointestinal endoscopy is particularly challenging because of variability during most procedures, characterized by long nonstimulating periods interspersed with significantly stimulating events. Use of a medication reconciliation tool is associated with significant improvements in patient safety.
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Publisher: Cambridge University Press
Print publication year: 2012

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