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RISK MANAGEMENT FOR SEDATION IN ENDOSCOPIC SUBMUCOSAL DISSECTION
Author(s) -
Naruse Mutsuko,
Inatsuchi Shuji
Publication year - 2007
Publication title -
digestive endoscopy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.5
H-Index - 56
eISSN - 1443-1661
pISSN - 0915-5635
DOI - 10.1111/j.1443-1661.2007.00718.x
Subject(s) - medicine , sedation , anesthesia , perforation , endoscopic submucosal dissection , decompression , prone position , dissection (medical) , surgery , pulse oximetry , intensive care medicine , materials science , punching , metallurgy
Endoscopic submucosal dissection takes a longer time to complete, and special attention is needed for patient risk management. Narcotics and benzodiazepines to produce conscious sedation is familiar to the endoscopist. General anesthesia should be indicated for difficult cases. To provide early warning for respiratory compromise, pulse oximetry, capnometer, and continuous visual assessment by trained stuff are needed. On lateral position, axillar vessels and nerve may be damaged, decompression pad is useful. Complications of ESD are not limited to bleeding or perforation, sedation‐related complications are also possible. Education and training for medical personnel is essential to prevent adverse events.