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Related Concept Videos

Endoscopic Procedures I: Esophagogastroduodenoscopy01:29

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An Esophagogastroduodenoscopy (EGD) is a diagnostic procedure in which an endoscopist uses a flexible, lighted endoscope to visualize the upper gastrointestinal (GI) tract. The procedure includes visualizing the oropharynx, esophagus, stomach, and the first part of the small intestine, the duodenum.
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Endoscopic Procedures II: Colonoscopy01:25

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The colon, or large intestine, is the final segment of the digestive system. Its primary functions include absorbing water and vitamins produced by gut bacteria and transforming waste from liquid to solid to form stool. In adults, the large intestine is approximately 5 feet long and consists of four main sections:
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Endoscopic Procedures V: ERCP01:26

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Sigmoidoscopy and laparoscopy are distinct medical procedures that enable physicians to internally inspect different parts of the GI tract. Although they serve different purposes, each is essential for diagnosing and, in some cases, treating various medical conditions.
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Meaning of Cystoscopic Examination:Cystoscopy is an essential diagnostic tool in urology that is used to assess the structure and function of the genitourinary system. It provides a direct view of the urethra, bladder, and, in some cases, the ureteral openings. This procedure helps detect structural abnormalities, infections, cancers, and blockages in the urinary tract. There are two types of cystoscopy:Flexible cystoscopy is commonly performed in outpatient settings due to its less invasive...
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Updated: Feb 10, 2026

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Nonoperating room anesthesia for gastrointestinal endoscopic procedures.

Otto S Lin1, Wade Weigel2

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Current Opinion in Anaesthesiology
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Nonoperating room anesthesia (NORA) for gastrointestinal endoscopy is increasing, raising costs. Alternative propofol sedation methods by non-anesthesiologists for low-risk patients may optimize resource allocation and reduce expenses.

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Area of Science:

  • Anesthesiology
  • Gastroenterology
  • Health Services Research

Background:

  • Nonoperating room anesthesia (NORA) for gastrointestinal endoscopy has seen a steady rise in the United States over the past decade.
  • This increasing trend in NORA has been associated with considerable escalation in healthcare expenditures.
  • Concerns over rising costs have prompted exploration of alternative sedation delivery methods for specific patient groups.

Purpose of the Study:

  • To evaluate the recent trends in the utilization of NORA for gastrointestinal endoscopic procedures.
  • To examine and describe alternative strategies for administering propofol sedation.
  • To focus on methods suitable for selected low-risk patients undergoing these procedures.

Main Methods:

  • Review of trends in NORA utilization for gastrointestinal endoscopy.
  • Description of alternative propofol sedation modalities.
  • Analysis of safety and efficacy of non-anesthesiologist-administered propofol sedation.

Main Results:

  • The utilization of NORA for routine gastrointestinal endoscopy has been progressively increasing.
  • Alternative methods such as nurse-administered propofol sedation and computer-assisted propofol sedation are being developed for low-risk patients.
  • There is ongoing debate regarding the safety of propofol administration by trained non-anesthesia personnel.

Conclusions:

  • Implementing non-anesthesia-administered propofol sedation for low-risk procedures can lead to better allocation of anesthesia resources.
  • This approach may help mitigate shortages in anesthesia provider supply and potentially lower overall healthcare costs.
  • Ensuring sedation quality is paramount when considering these alternative methods for gastrointestinal endoscopy.