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Anesthesia for Colonoscopy and Lower Endoscopic Procedures.

John Michael Trummel1, Vinay Chandrasekhara2, Michael L Kochman2

  • 1Anesthesiology, Dartmouth Hitchcock Medical Center, 1 Medical Center Drive, Lebanon, NH 03756, USA.

Anesthesiology Clinics
|November 6, 2017
PubMed
Summary
This summary is machine-generated.

Anesthesiologist-assisted sedation for lower endoscopy is increasing but not always necessary. Different sedation levels, including no sedation, offer comparable outcomes for patients undergoing gastrointestinal procedures.

Keywords:
AnesthesiaColonoscopyDeep sedationLower endoscopic proceduresModerate sedationOutcomesPropofol

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Area of Science:

  • Gastroenterology
  • Anesthesiology

Background:

  • Anesthesiologist-assisted sedation is increasingly used for lower endoscopic procedures, potentially increasing costs.
  • Most lower endoscopies can be performed with varying sedation levels, from none to deep, with general anesthesia rarely required.

Purpose of the Study:

  • To evaluate the necessity and impact of different sedation strategies for lower gastrointestinal endoscopic procedures.

Main Methods:

  • Review of sedation practices for lower endoscopy, including no sedation, moderate sedation (benzodiazepines and opiates), deep sedation (propofol-based), and general anesthesia.
  • Comparison of outcomes across different sedation groups.

Main Results:

  • Propofol-based sedation offers benefits in patient satisfaction and recovery compared to other methods.
  • Moderate sedation with benzodiazepines and opiates is effective for low-risk patients and procedures.
  • No sedation is a viable option for routine colonoscopies in selected patients, eliminating sedation-related risks.
  • No significant difference in outcome measures was observed based on the type of sedation received.

Conclusions:

  • Anesthesiologist-assisted sedation is not always required for lower gastrointestinal endoscopy.
  • Sedation strategies should be tailored to patient risk and procedure type, with options ranging from no sedation to deep sedation.
  • Outcome measures are comparable across different sedation modalities, suggesting careful selection is key.