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Sedation in Gastrointestinal Endoscopy: From Drug-Centered Protocols to Personalized, Technology-Supported Pathways:
Giuliano Francesco Bonura1, Paola Soriani1, Noemi Gualandi1
1Gastroenterology and Digestive Endoscopy Unit, Azienda USL di Modena, 41121 Modena, Italy.
Journal of Clinical Medicine
|June 12, 2026
Summary
Gastrointestinal endoscopy sedation is shifting towards personalized, technology-assisted approaches. New drugs and monitoring enhance safety and efficiency for patients undergoing endoscopic procedures.
Area of Science:
- Gastroenterology
- Anesthesiology
- Medical Technology
Background:
- Sedation is crucial for gastrointestinal endoscopy, but traditional methods face challenges with increasing procedure volumes and an aging population.
- Limited anesthesiology resources necessitate innovative sedation strategies.
Purpose of the Study:
- To review evolving pharmacological agents, monitoring techniques, and organizational models for sedation in gastrointestinal endoscopy.
- To explore future directions for personalized, technology-supported sedation pathways.
Main Methods:
- A narrative review synthesizing evidence from PubMed/MEDLINE, Scopus, and Web of Science (2010-2025).
- Inclusion of guidelines, RCTs, meta-analyses, and observational studies, with qualitative evidence synthesis.
Main Results:
- Propofol is common but has safety limits; remimazolam and ciprofol offer improved safety profiles, especially for elderly patients.
- Advanced monitoring (capnography, BIS) and adjunctive strategies (spinal anesthesia) can enhance safety.
- Structured training and standardized discharge criteria are vital for quality.
Conclusions:
- Gastrointestinal endoscopy sedation is moving towards personalized, risk-adapted, and technology-supported models.
- Integrating novel agents, advanced monitoring, and training is key for patient safety, procedural efficiency, and healthcare sustainability.
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