S3 Guideline: Sedation for gastrointestinal endoscopy 2008

Contents

Introduction
1 Indications/goals/known risks/patients/quality goals
1.1 Recommendation on sedation choices
1.2 Recommendation on indications for sedation
1.3 Recommendation on examination quality
1.4 Recommendation on risk assessment and structure quality
1.4.1 General
1.5 Recommendation on anesthesia/intubation
1.6 Recommendation on protective intubation
1.7 Recommendation on patient positioning
2 Sedatives/analgesics/drugs acting on the autonomic nervous system/combination therapy/methods of administration
2.1 Acceptance by the patient and the endoscopist
2.1.1 Patient acceptance/satisfaction
2.1.2 Endoscopist satisfaction
2.2 Monotherapies
2.2.1 Propofol
2.2.2 Benzodiazepines
2.2.3 Propofol versus midazolam
2.2.4 Other drugs as monotherapeutics
2.3 Combination therapies
2.3.1 General
2.3.2 Specific combinations
2.3.3 Side effects of combination therapy
2.3.4 Monitoring/structure quality
2.4 Effect of co-morbidity
2.4.1 General
2.4.2 High-risk patients
2.4.3 Substance type
2.5 Music during endoscopy
3 Structure quality: personal/personnel/equipment requirements
Introduction
3.1 Personal requirements
3.2 Education and training courses
3.3 Personnel requirements
3.3.1 Education requirements
3.3.2 Sedation monitoring
3.3.3 Carrying out the sedation
3.3.4 Monitoring after the endoscopic procedure
3.4 Facilities requirements
3.5 Equipment
3.5.1 Clinical monitoring/standard monitoring
3.5.2 Extended monitoring
4 Informed consent/prerequisites for performance of sedation/preservation of vital functions/clinical monitoring/emergency management
4.1 Informed consent of the patient
4.1.1 General and legal aspects
4.1.2 Informing person
4.1.3 Informed consent procedure
4.1.4 Content of the patient information interview
4.1.5 Safety information (patient do’s and don’t’s after endoscopic sedation)
4.2 Requirements for carrying out sedation
4.3 Protection of vital functions
4.4 Management of sedation-related emergencies
4.4.1 Hypoxemia
4.4.2 Cardiac arrhythmias
4.4.3 Arterial hypotension
4.4.4 Myocardial ischemia
4.4.5 Rare events during sedation
5 Quality goals: internal quality assurance/discharge criteria/fitness for road traffic/ability to work/documentation/benchmarking
5.1 Internal quality assurance
5.2 Discharge criteria
5.2.1 Patient instructions
5.2.2 Minimum criteria for discharge
5.2.3 Use of score systems for discharge
5.3 Fitness for road traffic
5.4 Documentation
5.4.1 General
5.4.2 Inability to work
5.5 Benchmarking

References

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