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Review on sedation for gastrointestinal tract endoscopy in children by non-anesthesiologists

Rok Orel1, Jernej Brecelj1, Jorge Amil Dias1

  • 1Rok Orel, Jernej Brecelj, Children's Hospital, University Medical Centre Ljubljana, and Medical Faculty, University of Ljubljana, 1000 Ljubljana, Slovenia.

World Journal of Gastrointestinal Endoscopy
|August 5, 2015
PubMed

Insights

Non-anesthesiologists can use ketamine or benzodiazepine/opioid combinations for pediatric gastrointestinal endoscopy sedation. While propofol is effective, legal restrictions limit its use by non-anesthesiologists.

Area of Science:

  • Pediatric Gastroenterology
  • Sedation Management
  • Endoscopic Procedures

Background:

  • Sedation is crucial for pediatric gastrointestinal (GI) endoscopy.
  • Non-anesthesiologists frequently administer sedation in this setting.
  • Evidence-based recommendations are needed for safe and effective sedation practices.

Purpose of the Study:

  • To review evidence on sedation for pediatric GI endoscopy.
  • To formulate recommendations for non-anesthesiologists performing these procedures.
  • To evaluate different sedation agents and protocols.

Main Methods:

  • Systematic literature search of MEDLINE, Cochrane, and EMBASE databases.
  • Keywords included "endoscopy, GI", "sedation", and various sedation levels.
  • Focus on English-language publications for pediatric age group (2011-2014).

Main Results:

  • Propofol offers optimal efficacy and safety but is underutilized by non-anesthesiologists due to legal barriers.
  • Ketamine and benzodiazepine/opioid combinations are commonly employed.
  • Data on other sedatives, anesthetics, and adjuvant medications were also reviewed.

Conclusions:

  • General anesthesia by an anesthesiologist-led team is the preferred approach.
  • Sedation teams led by non-anesthesiologists can be an alternative.
  • Drug selection must comply with national and institutional regulations.
Abstract

Keywords:
AnalgesicsAnestheticsColonoscopyGastro-intestinal endoscopyGastroscopyPediatric agesSedatives

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