Pre-anesthetic evaluation for gastrointestinal endoscopy in China: a national web-based questionnaire survey

In China, the demand for sedation during gastrointestinal endoscopy (GIE) has surged since the introduction of the nationwide Cancer Screening Program in 2012, while anesthesia staffing remains insufficient. Pre-anesthetic evaluation (PAE) is crucial for safe sedation, however, PAE practices in China have not been thoroughly examined.

We conducted a national web-based questionnaire survey among anesthesiologists across China from January to February 2024, focusing on PAE and sedation practices for GIE.

A total of 413 anesthesiologists from 282 hospitals across the 31 provincial-level administrative regions of mainland China (Taiwan, Hong Kong and Macao were not included) participated. Key findings included: Dual PAE timing (before and on the day of GIE) significantly reduced same-day procedure cancellations (15.2% vs. 31.5%, p < 0.01); Preoperative testing was dominated by non-risk-stratified ECG (95.0%) despite limited evidence; and significant variability existed in assessment strategies among anesthesiologists, unrelated to professional seniority or hospital level.

This survey reveals critical gaps in China's PAE practices for GIE. Aligning PAE practices with evidence-based protocols and embracing digital health innovations could optimize perioperative safety and mitigate anesthesia workforce challenges. These measures may significantly enhance perioperative care for GIE patients in China. Moreover, the findings highlight critical educational gaps and provide insights for curriculum design and competency-based training in anesthesia and endoscopy sedation, which may significantly enhance the quality of perioperative care for GIE patients in China.