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Endoscopy 2015; 47(04): 383-390
DOI: 10.1055/s-0034-1391672
Newsletter SEED
© Georg Thieme Verlag KG Stuttgart · New York

Gastrointestinal Endoscopy Sedation and Monitoring Practices in Spain: A Nationwide Survey in the Year 2014

Alfredo J. Lucendo
1   Department of Gastroenterology, Hospital General de Tomelloso, Tomelloso, Spain
,
Ferrán González-Huix
2   Department of Gastroenterology, Hospital Arnau de Vilanova, Lleida, Spain
,
José M. Tenias
3   Unitat Docent de Medicina Familiar i Comunitària, Escola Valenciana d’Estudis de la Salut, EVES, Valencia, Spain
,
Leopoldo López-Rosés
4   Department of Digestive Diseases, Hospital Universitario Lucus Augusti, Lugo, Spain
,
Pedro Alonso-Aguirre
5   Department of Gastroenterology, Complejo Hospitalario Universitario, A Coruña, Spain
,
Enrique Quintero
6   Department of Gastroenterology, Hospital Universitario de Canarias, La Laguna, Tenerife
,
Miguel Muñoz-Navas
7   Department of Gastroenterology, Clínica Universidad de Navarra, Pamplona, Spain
,
on behalf of the Spanish Society of Digestive Diseases, the Spanish Society of Digestive Endoscopy, and the Spanish Association of Gastroenterology › Author Affiliations
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Publication History

Publication Date:
31 March 2015 (online)

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Background and study aims: The introduction of new sedative agents and a desire for improved patient care have encouraged the use of sedation for gastrointestinal (GI) endoscopy over the last decade. This survey aims to provide, within Spain, national and regional data on gastroenterologists’ endoscopic sedation and monitoring practices, and on their attitudes concerning these practices.

Methods: A 19-item survey covering the current practices of sedation and monitoring in GI endoscopy was electronically mailed to all members of the three nationwide scientific societies.

Results: Of 2476 e-mailed questionnaires, a total of 569 (23 %) were returned, proportionally representing the structure of the Spanish health care system. Monitoring and resuscitation resources were universally available, as well as post-endoscopy recovery rooms. Endoscopy teams usually included a registered nurse (98.5 %), an auxiliary nurse (80.5 %), and other physicians (25.7 %), generally anesthesiologists. More than half of esophagogastroduodenoscopies (EGDs) are performed with the patient under sedation; in 25 % of centers, more than 95 % colonoscopies are performed with the patient sedated, but a wide variation was observed. Pre-endoscopic risk is assessed in the vast majority of procedures. Propofol is the most commonly used sedative, either alone (in 70 % of EGDs and 80 % of colonoscopies) or in combination with other drugs. Private funding of a clinic was the only predictor of a significant increase in the use of sedation; 57.7 % of the respondents stated having difficulties in implementing sedation, with the limited availability of anesthesiologists and resuscitation training for the auxiliary staff the most common complaints.

Conclusions: The use of sedation during GI endoscopy in Spain varies widely but is on the increase and is more common in private practice. Propofol is the preferred sedative in all procedures.

 

  • References

  • 1 McQuaid KR, Laine L. A systematic review and meta-analysis of randomized, controlled trials of moderate sedation for routine endoscopic procedures. Gastrointest Endosc 2008; 67: 910-923
    CrossrefPubMedGoogle Scholar
  • 2 Igea F, Casellas JA, Gonzalez-Huix F et al. Sedation for gastrointestinal endoscopy. Clinical practice guidelines of the Sociedad Española de Endoscopia Digestiva. Rev Esp Enferm Dig 2014; 106: 195-211
    PubMedGoogle Scholar
  • 3 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: 960-974
    Article in Thieme ConnectPubMedGoogle Scholar
  • 4 Cohen LB, DeLegge MH, Aisenberg J et al. AGA Institute review of endoscopic sedation. Gastroenterology 2007; 133: 675-701
    CrossrefPubMedGoogle Scholar
  • 5 Cohen LB, Ladas SD, Vargo JJ et al. Sedation in digestive endoscopy: the Athens international position statements. Aliment Pharmacol Ther 2010; 32: 425-442
    CrossrefPubMedGoogle Scholar
  • 6 Schreiber F. Austrian Society of Gastroenterology and Hepatology (OGGH) – guidelines on sedation and monitoring during gastrointestinal endoscopy. Endoscopy 2007; 39: 259-262
    Article in Thieme ConnectPubMedGoogle Scholar
  • 7 Riphaus A, Wehrmann T, Weber B et al. S3-guidelines--sedation in gastrointestinal endoscopy [in German]. Z Gastroenterol 2008; 46: 1298-1330
    Article in Thieme ConnectPubMedGoogle Scholar
  • 8 Riphaus A, Rabofski M, Wehrmann T. Endoscopic sedation and monitoring practice in Germany: results from the first nationwide survey. Z Gastroenterol 2010; 48: 392-397
    Article in Thieme ConnectPubMedGoogle Scholar
  • 9 Radaelli F, Meucci G, Minoli G. Colonoscopy practice in Italy: a prospective survey on behalf of the Italian Association of Hospital Gastroenterologists. Dig Liver Dis 2008; 40: 897-904
    CrossrefPubMedGoogle Scholar
  • 10 Paspatis GA, Manolaraki MM, Tribonias G et al. Endoscopic sedation in Greece: results from a nationwide survey for the Hellenic Foundation of gastroenterology and nutrition. Dig Liver Dis 2009; 41: 807-811
    CrossrefPubMedGoogle Scholar
  • 11 Riphaus A, Geist F, Wehrmann T. Endoscopic sedation and monitoring practice in Germany: re-evaluation from the first nationwide survey 3 years after the implementation of an evidence and consent based national guideline. Z Gastroenterol 2013; 51: 1082-1088
    Article in Thieme ConnectPubMedGoogle Scholar
  • 12 Baudet JS, Borque P, Borja E et al. Use of sedation in gastrointestinal endoscopy: a nationwide survey in Spain. Eur J Gastroenterol Hepatol 2009; 21: 882-888
    CrossrefPubMedGoogle Scholar
  • 13 Heuss LT, Froehlich F, Beglinger C. Nonanesthesiologist-administered propofol sedation: from the exception to standard practice. Sedation and monitoring trends over 20 years. Endoscopy 2012; 44: 504-511
    Article in Thieme ConnectPubMedGoogle Scholar
  • 14 Cohen LB, Wecsler JS, Gaetano JN et al. Endoscopic sedation in the United States: results from a nationwide survey. Am J Gastroenterol 2006; 101: 967-974
    CrossrefPubMedGoogle Scholar
  • 15 Campo R, Brullet E, Junquera F et al. Sedation in digestive endoscopy. Results of a hospital survey in Catalonia (Spain). Gastroenterol Hepatol 2004; 27: 503-507
    CrossrefPubMedGoogle Scholar
  • 16 Herrerias Gutierrez JM, Arguelles AF. Results of a survey in Andalusian endoscopy units. Rev Esp Enferm Dig 2006; 98: 929-948
    PubMedGoogle Scholar
  • 17 Cubiella FJ, Lancho SA, Echarri PA et al. Sedation at endoscopic units in Galicia: results of the “Sociedad Gallega de Patologia Digestiva” inquiry. Rev Esp Enferm Dig 2005; 97: 24-37
    PubMedGoogle Scholar
  • 18 Riphaus A, Macias-Gomez C, Deviere J et al. Propofol, the preferred sedation for screening colonoscopy, is underused. Results of an international survey. Dig Liver Dis 2012; 44: 389-392
    CrossrefPubMedGoogle Scholar
  • 19 Repici A, Pagano N, Hassan C et al. Balanced propofol sedation administered by nonanesthesiologists: the first Italian experience. World J Gastroenterol 2011; 17: 3818-3823
    CrossrefPubMedGoogle Scholar
  • 20 Simon MA, Bordas JM, Campo R et al. Consensus document of the Spanish Association of Gastroenterology on sedoanalgesia in digestive endoscopy. Gastroenterol Hepatol 2006; 29: 131-149
    CrossrefPubMedGoogle Scholar
  • 21 Lopez RosésL. Subcomité de Protocolos of the Spanish Society of Gastrointestinal Endoscopy (SEED). Sedation/analgesia guidelines for endoscopy. Rev Esp Enferm Dig 2006; 98: 685-692
    PubMedGoogle Scholar
  • 22 Gonzalez-Huix LF, Gine Gala JJ, Loras AC et al. Position statement of the Catalan Society of Digestology on sedation in gastrointestinal endoscopy. Gastroenterol Hepatol 2012; 35: 496-511
    CrossrefPubMedGoogle Scholar
  • 23 Qadeer MA, Vargo JJ, Khandwala F et al. Propofol versus traditional sedative agents for gastrointestinal endoscopy: a meta-analysis. Clin Gastroenterol Hepatol 2005; 3: 1049-1056
    CrossrefPubMedGoogle Scholar
  • 24 Singh H, Poluha W, Cheung M et al. Propofol for sedation during colonoscopy. Cochrane Database Syst Rev 2008; CD006268
    PubMedGoogle Scholar
  • 25 Baudet JS, Aguirre-Jaime A. The sedation increases the acceptance of repeat colonoscopies. Eur J Gastroenterol Hepatol 2012; 24: 775-780
    CrossrefPubMedGoogle Scholar
  • 26 Heuss LT, Froehlich F, Beglinger C. Changing patterns of sedation and monitoring practice during endoscopy: results of a nationwide survey in Switzerland. Endoscopy 2005; 37: 161-166
    Article in Thieme ConnectPubMedGoogle Scholar
  • 27 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: 496-504
    Article in Thieme ConnectPubMedGoogle Scholar