https://doi.org/10.4081/scenario.2021.461
Nursing management of deep sedation in digestive endoscopy: a narrative review of the literature
Submitted: 11 April 2021
Accepted: 11 April 2021
Published: 11 April 2021
Accepted: 11 April 2021
Abstract Views: 735
PDF (Italiano): 222
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Authors
The Italian Society of Digestive Endoscopy (SIED) has published a document stating that Propofol can be administered by appropriately trained gastroenterologists and endoscopy nurses. In order to ensure the quality and safety of sedation when performed by non-anaesthetists, specific and adequate training is required to facilitate its correct implementation, which must comply with the latest recommendations. The aim of this study is to verify the effectiveness and safety of deep sedation in endoscopy performed by nurses.
Bashiri M, Akçalı D, Coşkun D, Cindoruk M, Dikmen A, Çifdalöz BU. Evaluation of pain and patient satisfaction by music therapy in patients with endoscopy/colonoscopy. Turk J Gastroenterol. 2018 Sep;29(5):574–9.
Cohen LB, Ladas SD, Vargo JJ et al. Sedation in digestive endoscopy: the Athens international position statement. Aliment Pharmacol Ther 2010: PMID: 20456310
Metwally M. Conscious or unconscious: The impact of sedation choice on colon adenoma detection. WJG. 2011;17(34):3912.
Poulos JE, Kalogerinis PT, Caudle JN. Propofol compared with combination Propofol or Midazolam/fentanyl for endos- copy in a community setting. AANA J 2013;81:31–6.
McEntire J, Sahota J, Hydes T, Trebble TM. An evaluation of patient attitudes to colonoscopy and the importance of endoscopist interaction and the endoscopy environment to satisfaction and value. Scand J Gastroenterol 2013;48:366–73.
Mackenzie N, Grant IS. Propofol for intravenous sedation. Anaesthesia 1987;42:3-6.
Riphaus A, Geist F, Wehrmann T. Endoscopic sedation and monitoring practice in Germany: re- evaluation from the first nationwide survey 3 years after the implementation of an evidence and consent based national guideline. Z Gastroenterol. 2013 Sep;51(9):1082–8.
Lera dos Santos ME, Maluf-Filho F, Chaves DM, et al. Deep sedation during gastrointestinal endoscopy: Propofol-fentanyl and Midazolam-fentanyl regimens. World J Gastroenterol 2013;19(22):3439-46.
Dewitt J, McGreevy K, Sherman S, Imperiale TF. Nurse-administered propofol sedation compared with midazolam and meperidine for EUS: a prospective, randomized trial. Gastrointest Endosc. 2008 Sep;68(3):499-509.
Tsai H-C, Lin Y-C, Ko C-L, Lou H-Y, Chen T-L, Tam K-W, et al. Propofol versus Midazolam for Upper Gastrointestinal Endoscopy in Cirrhotic Patients: A Meta-Analysis of Randomized Controlled Trials. PLoS ONE. 2015 Feb 3;10(2):e0117585.
Rex DK, Deenadayalu VP, Eid E, Imperiale TF, Walker JA, Sandhu K et al. Endoscopist-directed administration of propofol: a worldwide safety experience. Gastroenterology. 2009 Oct;137(4):1229-37;
Khemasuwan D, Teerapuncharoen K, Griffin DC. Diagnostic Yield and Safety of Bronchoscopist- directed Moderate Sedation With a Bolus Dose Administration of Propofol During Endobronchial Ultrasound Bronchoscopy. J Bronchology Interv Pulmonol. 2018 Jul;25(3):181–8.
Inadomi JM, Gunnarsson CL, Rizzo JA, Fang H. Projected increased growth rate of anesthesia professional-delivered sedation for colonoscopy and EGD in the United States: 2009 to 2015. Gastrointest Endosc. 2010 Sep;72(3):580-6.
Cohen LB, Wecsler JS, Gaetano JN, Benson AA, Miller KM, Durkalski V et al. Endoscopic sedation in the United States: results from a nationwide survey. Am J Gastroenterol. 2006 May;101(5):967-74.
Harewood G. Colonoscopy practice patterns since introduction of medicare coverage for average-risk screening. Clinical Gastroenterology and Hepatology. 2004 Jan;2(1):72–7.
Osservatorio Nazionale Screening, Lo screening colorettale. [citato 2020 Gem 10]. Visionabile da: https://www.osservatorionazionalescreening.it/content/lo-screening-colorettale
Heuss LT, Froehlich F, Beglinger C. Changing patterns of sedation and monitoring practice during endoscopy: results of a nationwide survey in Switzerland. Endoscopy 2005; 37: 161 – 166
Fanti L, Agostoni M, Gemma M et al. Italian Society of Digestive En- doscopy Sedation Commission: Sedation and monitoring for gastrointestinal endoscopy: A nationwide web survey in Italy. Dig Liver Dis 2011; 43: 726 – 730
Aisenberg J, Brill JV, Ladabaum U, Cohen LB. Sedation for gastrointestinal endoscopy: new practices, new economics. Am J Gastroenterol. 2005 May;100(5):996-1000.
Dumonceau JM, Riphaus A, Aparicio JR et al. European Society of Gastrointestinal Endoscopy, European Society of Gastroenterology and Endoscopy Nurses and Associates, and the European Society of Anaesthesiology Guideline: Non-anesthesiologist administration of Propofol for GI endoscopy. Endoscopy 2010; 42: 960 – 974
Rex DK. Review article: moderate sedation for endoscopy: sedation regimens for non- anaesthesiologists. Aliment Pharmacol Ther 2006; 24: 163 – 171
Birk J, Bath RK. Is the anesthesiologist necessary in the endoscopy suite? A review of patients, payers and safety. Expert Review of Gastroenterology & Hepatology. 2015 Jul 3;9(7):883–5.
Dumonceau J-M, Riphaus A, Schreiber F, Vilmann P, Beilenhoff U, Aparicio J, et al. Non- anesthesiologist administration of Propofol for gastrointestinal endoscopy: European Society of Gastrointestinal Endoscopy, European Society of Gastroenterology and Endoscopy Nurses and Associates Guideline – Updated June 2015. Endoscopy. 2015 Nov 12;47(12):1175–89.
Conigliaro R, Fanti L. La sedazione in endoscopia digestiva. Giorn Ital End Dig 2014;37:223-227
Matsusaki T, Sakai T. The role of Certified Registered Nurse Anesthetists in the United States. J Anesth. 2011 Oct;25(5):734–40.
Walker JA, McIntyre RD, Schleinitz PF, Jacobson KN, Haulk AA, Adesman P, et al. Nurse- administered Propofol sedation without anesthesia specialists in 9152 endoscopic cases in an ambulatory surgery center. Am J Gastroenterol 2003; 98:1744–50
Petrocco M. Right time for Propofol? A 4-year experience in an Italian center. 22nd ESGENA Conference; Vienna, 2018. 53.
Mercado-LongorÃa R, Armeaga-Azoños C, Tapia-Orozco J, González-Aguirre JE. Non- anesthesiologist-administered Propofol is not Related to an Increase in Transcutaneous CO2 Pressure During Flexible Bronchoscopy Compared to Guideline-based Sedation: A Randomized Controlled Trial. Arch Bronconeumol. 2017 Sep;53(9):489–94.
Goudra BG, Singh PM. SEDASYS, sedation, and the unknown. J Clin Anesth. 2014; 26:334–336.
Goudra BG, Singh PM, Chandrasekhara V. SEDASYS®, airway, oxygenation, and ventilation: anticipating and managing the challenges. Dig Dis Sci. 2014; 59:920–927.
Igea F, Casellas JA, González-Huix F, et al. Sedación en endoscopia di- gestiva. GuÃade práctica clÃnica de la Sociedad Española de Endoscopia Digestiva. Rev Esp Enferm Dig 2014; 106:195-211.
Dumonceau JM, Riphaus A, Beilenhoff U, Vilmann P, Hornslet P, Aparicio JR et al. European curriculum for sedation training in gastrointestinal endoscopy: position statement of the European Society of Gastrointestinal Endoscopy (ESGE) and European Society of Gastroenterology and Endoscopy Nurses and Associates (ESGENA). Endoscopy. 2013 Jun;45(6):496-504.
Ferrari R. Writing narrative style literature reviews. Medical Writing. 2015 Dec 1;24(4):230–5.
Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gøtzsche PC, Clarke M, et al. PRISMA Statement per il reporting di revisioni sistematiche e meta-analisi degli studi che valutano gli interventi sanitari: spiegazione ed elaborazione. OPEN ACCESS. 2015;7(6):36.
Jensen JT, Møller A, Hornslet P, Konge L, Vilmann P. Moderate and deep nurse-administered Propofol sedation is safe. Dan Med J. 2015;4(62):A5049–A5049.
Gurung R, Purbe B, Malla B, Dhungel A, Yogol S, Poudel A, et al. Safety Profile and Patient Satisfaction of the Routine use of Propofol in Gastrointestinal Endoscopy. Kathmandu Univ Med J. 2015 Oct 13;12(2):101–5.
Aumpansub P, Ridtitid W, Prueksapanich P, Wiangngoen S, Ponauthai YY, Sumbin S, et al. Mo1081 Propofol Sedation by the Nurse Under the Endoscopist’s Supervision for Outpatient Colonoscopy: Impact on Safety and Endoscopic Unit Utilization. Gastrointestinal Endoscopy. 2017 May;85(5):AB 419.
Riesco Lopez JM, Rizo Pascual JM, Fernandez PG, Sanchez AD, Fernandez MR, Fernandez RM, et al. 63 Nurse Administered Propofol Sedation (NAPS) Is More Efficient than Anaesthesiologist Administered Sedation With Propofol (AAP) for Endoscopic Procedures in Patients at Low- Intermediate Anesthetic Risk. Gastrointestinal Endoscopy. 2017 May;85(5): AB50.
GarcÃa Aguilera X, Justo LMA, González Pino A, Izquierdo MDR, Blázquez Gómez I, Van Domselaar M. Sa1485 Safety of Propofol Administered by Gastroenterologists and Trained Nurses in an Endoscopy Unit. a Single Center Prospective Study. Gastrointestinal Endoscopy. 2015 May;81(5):AB233.
GarcÃa-Suárez C, López-Rosés L, Olivencia P, Lancho A, González-RamÃrez A, Santos E, et al. Sedation with Propofol controlled by endoscopists during percutaneous endoscopic gastrostomy. Rev esp enferm dig. 2010 Apr 102(4).
Slagelse C, Vilmann P, Hornslet P, Hammering A, Mantoni T. Nurse-administered Propofol sedation for gastrointestinal endoscopic procedures: ï¬rst Nordic results from implementation of a structured training program. Scand J Gastroenterol 2011;46:1503–9.
Coté GA, Hovis RM, Ansstas MA, Waldbaum L, Azar RR, Early DS, et al. Incidence of Sedation- Related Complications With Propofol Use During Advanced Endoscopic Procedures. Clinical Gastroenterology and Hepatology. 2010 Feb;8(2):137–42
Gurung R, Purbe B, Malla B, Dhungel A, Yogol S, Poudel A, et al. Safety Profile and Patient Satisfaction of the Routine use of Propofol in Gastrointestinal Endoscopy. Kathmandu Univ Med J. 2015 Oct 13;12(2):101–5.
López Muñoz C, Sánchez Yagüe A, Canca Sánchez JC, Reinaldo-Lapuerta JA, Moya Suárez AB. Quality of sedation with Propofol administered by non-anesthetists in a digestive endoscopy unit: the results of a one year experience. Rev Esp Enferm Dig. 2018;110.
Al-Rashdan A, LeBlanc J, Sherman S, McHenry L, DeWitt J, Al-Haddad M. Role of Endoscopic Ultrasound for Evaluating Gastrointestinal Tract Disorders in Pediatrics: A Tertiary Care Center Experience: Journal of Pediatric Gastroenterology and Nutrition. 2010 Dec;51(6):718–22.
Adler DG, Kawa C, Hilden K, Fang J. Nurse-Administered Propofol Sedation Is Safe for Patients with Obstructive Sleep Apnea Undergoing Routine Endoscopy: A Pilot Study. Dig Dis Sci. 2011 Sep;56(9):2666–71.
Kawa C, Stewart J, Hilden K, Adler DG, Tietze C, Bromberg MB, et al. A Retrospective Study of Nurse-Assisted Propofol Sedation in Patients With Amyotrophic Lateral Sclerosis Undergoing Percutaneous Endoscopic Gastrostomy. Nutr Clin Pract. 2012 Aug;27(4):540–4.
Nilsson, A., Grossmann, B., Kullman, E., Uustal, E., Sjöberg, F. & Nilsson, L. (2015). Sedation during endoscopic retrograde cholangiopancreatography: A randomised controlled study of patient-controlled propofol sedation and that given by a nurse anaesthetist. Scandinavian Journal of Gastroenterology, 50(10), 1285-1292
Bastaki M, Douzinas EE, Fotis TG, Bakos DS, Mitsos AP, Argyra E, et al. A Randomized Double- Blind Trial of Anesthesia Provided for Colonoscopy by University-Degreed Anesthesia Nurses in Greece: Safety and Efficacy. Gastroenterology Nursing. 2013;36(3):223–30.
Okholm C, HadiKhadem T, Andersen LT, Donatsky AM, Vilmann P, Achiam MP. No increased risk of perforation during colonoscopy in patients undergoing Nurse Administered Propofol Sedation. Scandinavian Journal of Gastroenterology. 2013 Nov;48(11):1333–8.
Hassan C, Rex DK, Cooper GS, Benamouzig R. Endoscopist-directed Propofol administration versus anesthesiologist assistance for colorectal cancer screening: a cost-effectiveness analysis. Endoscopy. 2012 May;44(5):456–64.
Kayaaltı S, Kayaaltı Ö. Safety of applying Midazolam-ketamine-Propofol sedation combination under the supervision of endoscopy nurse with patient-controlled analgesia pump in colonoscopy. World J Clin Cases. 2018 Dec 26;6(16):1146–54.
Lin OS. Sedation for routine gastrointestinal endoscopic procedures: a review on efficacy, safety, efficiency, cost and satisfaction. Intest Res. 2017;15(4):456–466.
Overley CA, Rex DK. A nursing perspective on sedation and nurse-administered Propofol for endoscopy. Gastrointest Endosc Clin N Am. 2004;14(2):325–333.
Weston BR, Chadalawada V, Chalasani N, et al. Nurse-administered Propofol versus Midazolam and meperidine for upper endoscopy in cirrhotic patients. Am J Gastroenterol. 2003;98(11):2440–2447.
Polter DE. Risk of colon perforation during colonoscopy at Baylor University Medical Center. Proc (Bayl Univ Med Cent). 2015;28(1):3–6
Cohen LB, Dubovsky AN, Aisenberg J, Miller KM. Propofol for endoscopic sedation: A protocol for safe and effective administration by the gastroenterologist. Gastrointest Endosc. 2003;58(5):725–732.
Rex DK, Heuss LT, Walker JA, Qi R. Trained registered nurses/endoscopy teams can administer Propofol safely for endoscopy. Gastroenterology. 2005;129(5):1384–1391.
Chen SC, Rex DK. Review article: registered nurse-administered Propofol sedation for endoscopy. Aliment Pharmacol Ther. 2004;19(2):147–155. doi:10.1111/j.0269-2813.2004.01833.x
Supporting Agencies
How to Cite
Minciullo, A., Colombo, B., Renzi, E., & Filomeno, L. (2021). Nursing management of deep sedation in digestive endoscopy: a narrative review of the literature. Scenario® - Il Nursing Nella Sopravvivenza, 38(1), 7–15. https://doi.org/10.4081/scenario.2021.461
Copyright (c) 2021 Scenario
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Aniarti has chosen to apply the Creative Commons Attribution NonCommercial 4.0 International License (CC BY-NC 4.0) to all manuscripts to be published.