Open AccessAcademy of Medicine, Singapore clinical guideline on the use of sedation by non-anaesthesiologists during gastrointestinal endoscopy in the hospital setting
Author(s) -
Tiing Leong Ang,
Edwin Seet,
Yaw Chong Goh,
Wee Khoon Ng,
Calvin Jianyi Koh,
Hock Foong Lui,
Weiquan Li,
Aung Myint Oo,
Kieron Lim,
Kok-Yuen Ho,
Min Hoe Chew,
Wai Leong Quan,
Damien Meng Yew Tan,
Kheng Hong Ng,
Hak Su Goh,
Wai Kit Cheong,
Philip Tseng,
Khoon Lin Ling
Publication year - 2022
Publication title -
annals, academy of medicine, singapore/annals of the academy of medicine, singapore
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.299
H-Index - 60
ISSN - 0304-4602
DOI - 10.47102/annals-acadmedsg.2021306
Subject(s) - medicine , sedation , guideline , workgroup , endoscopy , propofol , therapeutic endoscopy , anesthesia , intensive care medicine , surgery , computer network , pathology , computer science
In Singapore, non-anaesthesiologists generally administer sedation during gastrointestinalendoscopy. The drugs used for sedation in hospital endoscopy centres now include propofol in additionto benzodiazepines and opiates. The requirements for peri-procedural monitoring and dischargeprotocols have also evolved. There is a need to develop an evidence-based clinical guideline on thesafe and effective use of sedation by non-anaesthesiologists during gastrointestinal endoscopy in thehospital setting.Methods: The Academy of Medicine, Singapore appointed an expert workgroup comprising 18gastroenterologists, general surgeons and anaesthesiologists to develop guidelines on the use ofsedation during gastrointestinal endoscopy. The workgroup formulated clinical questions related todifferent aspects of endoscopic sedation, conducted a relevant literature search, adopted Grading ofRecommendations, Assessment, Development and Evaluation (GRADE) methodology and developedrecommendations by consensus using a modified Delphi process.Results: The workgroup made 16 recommendations encompassing 7 areas: (1) purpose of sedation,benefits and disadvantages of sedation during gastrointestinal endoscopy; (2) pre-procedural assessment,preparation and consent taking for sedation; (3) Efficacy and safety of drugs used in sedation; (4) therole of anaesthesiologist-administered sedation during gastrointestinal endoscopy; (5) performanceof sedation; (6) post-sedation care and discharge after sedation; and (7) training in sedation forgastrointestinal endoscopy for non-anaesthesiologists.Conclusion: These recommendations serve to guide clinical practice during sedation for gastrointestinalendoscopy by non-anaesthesiologists in the hospital setting.Keywords: Benzodiazepines, gastrointestinal endoscopy opiates, propofol, sedation