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Endoscopist-directed propofol: pros and cons.

Eun Hye Kim1, Sang Kil Lee1

  • 1Division of Gastroenterology, Department of Internal Medicine, Institute of Gastroenterology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.

Clinical Endoscopy
|April 26, 2014
PubMed
Summary

Endoscopist-directed propofol (EDP) sedation is increasingly used for routine endoscopic procedures. While generally safe, careful consideration of anesthesiologist involvement for high-risk patients enhances safety.

Keywords:
Conscious sedationGastroenterologyPropofol

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Area of Science:

  • Gastroenterology
  • Anesthesiology
  • Patient Safety

Background:

  • Propofol is increasingly used for sedation during endoscopic procedures worldwide.
  • Concerns exist regarding the safety of endoscopist-directed propofol (EDP) administration.
  • The debate continues on whether endoscopists or anesthesiologists should administer sedation.

Purpose of the Study:

  • To discuss the safety and drawbacks of endoscopist-directed propofol (EDP) for routine endoscopic procedures.
  • To explore the controversy surrounding sedation administration in endoscopy.
  • To highlight the importance of endoscopist familiarity with propofol.

Main Methods:

  • Literature review and discussion of current practices regarding propofol use in endoscopy.
  • Analysis of safety concerns and benefits of EDP.
  • Exploration of the challenges in conducting randomized control trials comparing endoscopist vs. anesthesiologist administration.

Main Results:

  • Endoscopic procedures are generally well-tolerated with sedation.
  • No randomized control trials directly compare EDP administered by endoscopists versus anesthesiologists.
  • EDP is considered convenient for routine endoscopic procedures.

Conclusions:

  • Endoscopist-directed propofol (EDP) administration is a growing practice for endoscopic sedation.
  • While EDP offers convenience, anesthesiologist involvement may be beneficial for high-risk patients.
  • Further research or consensus is needed to standardize safe propofol administration in endoscopy.