Año 2017 / Volumen 109 / Número 2
Editorial
Will societies of anesthesiologists partake in the take-off of non-anesthesiologist administration of propofol?

87-90

DOI: 10.17235/reed.2017.4707/2016

Jean-Marc Dumonceau,

Resumen
Propofol sedation is increasingly used for standard and advanced endoscopies due to its advantages over traditional sedation based on benzodiazepines and/or opioids. These include a better sedation, greater patient cooperation, and higher patient satisfaction for most endoscopic procedures; it also decreases time to sedation and decreases recovery and discharge times. As anesthesiologists have typically provided propofol-based sedation, the increase in its use is limited by anesthesiologists’ availability and cost. Non-anesthesiologist administration of propofol has thus emerged as an alternative that is slowly gaining acceptance. This Editorial puts into perspective discussions that have recently taken place in Spain about the safety of non-anesthesiologist administration of propofol. It aims at refocusing the debate on facts, with the hope that an agreement between anesthesiologists, endoscopists and nurses will be achieved. Anesthesiologists’ support is essential to ensure that the transition that endoscopists are making from traditional to propofol sedation is safe.
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Bibliografía
1. Dumonceau JM, Riphaus A, Aparicio JR, et al. European Society of Gastrointestinal Endoscopy, European Society of Gastroenterology and Endoscopy Nurses and Associates, and the European Society of Anaesthesiology Guideline: Non-anesthesiologist administration of propofol for GI endoscopy. Endoscopy. 2010;42(11):960-974. doi:10.1055/s-0030-1255728.
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4. Vargo JJ, Niklewski PJ, Williams JL, et al. Patient safety during sedation by anesthesia professionals during routine upper endoscopy and colonoscopy: an analysis of 1.38 million procedures. Gastrointest Endosc. February 2016. doi:10.1016/j.gie.2016.02.007.
5. Poincloux L, Laquière A, Bazin J-E, et al. A randomized controlled trial of endoscopist vs. anaesthetist-administered sedation for colonoscopy. Dig Liver Dis. 2011;43(7):553-558. doi:10.1016/j.dld.2011.02.007.
6. Ferreira AO, Torres J, Barjas E, et al. Non-anesthesiologist administration of propofol sedation for colonoscopy is safe in low risk patients: results of a noninferiority randomized controlled trial. Endoscopy. 2016;48(8):747-753. doi:10.1055/s-0042-105560.
7. Pambianco DJ, Kudo S-E, Martin J. A Comparison of Propofol Sedation by an Anesthesiologist Versus A Gastroenterologist-Led Team Using the SEDASYS® System. Gastrointest Endosc. 2015;81(S):AB192. doi:10.1016/j.gie.2015.03.1946.
8. Goudra BG, Singh PM, Gouda G, et al. Safety of non-anesthesia provider-administered propofol (NAAP) sedation in advanced gastrointestinal endoscopic procedures: comparative meta-analysis of pooled results. Dig Dis Sci. March 2015. doi:10.1007/s10620-015-3608-x.
9. Adeyemo A, Bannazadeh M, Riggs T, et al. Does sedation type affect colonoscopy perforation rates? Dis Colon Rectum. 2014;57(1):110-114. doi:10.1097/DCR.0000000000000002.
10. Amornyotin S, Prakanrattana U, Kachintorn U, et al. Propofol-based sedation does not increase rate of perforation during colonoscopic procedure. Gastroenterol Insights. 2010;2(1):4. doi:10.4081/gi.2010.e4.
11. Bielawska B, Day AG, Lieberman DA, et al. Risk factors for early colonoscopic perforation include non-gastroenterologist endoscopists: a multivariable analysis. Clin Gastroenterol Hepatol. 2014;12(1):85-92. doi:10.1016/j.cgh.2013.06.030.
12. Okholm C, Hadikhadem T, Andersen LT, et al. No increased risk of perforation during colonoscopy in patients undergoing Nurse Administered Propofol Sedation. Scand J Gastroenterol. 2013;48(11):1333-1338. doi:10.3109/00365521.2013.837951.
13. Buxbaum J, Roth N, Motamedi N, et al. Anesthetist-directed sedation favors success of advanced endoscopic procedures. Am J Gastroenterol. July 2016. doi:10.1038/ajg.2016.285.
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15. Dumonceau JM, Riphaus A, Beilenhoff U, et al. European curriculum for sedation training in gastrointestinal endoscopy: position statement of the European Society of Gastrointestinal Endoscopy (ESGE) and European Society of Gastroenterology and Endoscopy Nurses and Associates (ESGENA). Endoscopy. 2013;45(6):496-504. doi:10.1055/s-0033-1344142.
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17. Jensen JT, Savran MM, Møller AM, et al. Development and validation of a theoretical test in non-anaesthesiologist-administered propofol sedation for gastrointestinal endoscopy. Scand J Gastroenterol. 2016;51(7):872-879. doi:10.3109/00365521.2016.1141433.
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Dumonceau J. Will societies of anesthesiologists partake in the take-off of non-anesthesiologist administration of propofol?. 4707/2016


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Ficha Técnica

Recibido: 02/11/2016

Aceptado: 26/11/2016

Prepublicado: 23/01/2017

Publicado: 31/01/2017

Tiempo de prepublicación: 82 días

Tiempo de edición del artículo: 90 días


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