Sedation by Non-Anesthesiologists During Endoscopic Procedures
Author Information
Author(s): Ishido Kenji, Tanabe Satoshi, Kitahara Gen, Furue Yasuaki, Wada Takuya, Watanabe Akinori, Matsuda Hiromi, Okamoto Hirotsugu, Kusano Chika
Primary Institution: Kitasato University School of Medicine
Hypothesis
The efficacy and safety of a sedation regimen combining dexmedetomidine and midazolam during endoscopic submucosal dissection for upper gastrointestinal tumors remains unclear.
Conclusion
A sedation regimen combining dexmedetomidine and midazolam can be feasibly administered by non-anesthesiologists.
Supporting Evidence
- All endoscopic submucosal dissection procedures were completed successfully.
- No severe sedation-related adverse events were reported.
- The median treatment time was 68 minutes for superficial esophageal cancer and 84 minutes for early gastric cancer and adenoma.
- The en-bloc resection rate was 92.2% for superficial esophageal cancer and 100% for early gastric cancer and gastric adenoma.
- All 22 non-anesthesiologists who underwent the proficiency evaluation passed the test.
Takeaway
Doctors who aren't anesthesiologists can safely give patients sedation during certain procedures using a specific combination of medications.
Methodology
The study retrospectively evaluated 68 patients who underwent endoscopic submucosal dissection, with sedation administered by non-anesthesiologists under supervision.
Potential Biases
Selection bias may exist due to the nature of clinical practice.
Limitations
The study was a single-center, retrospective, observational study without randomized controlled trials for comparison.
Participant Demographics
Median age was 74 years for superficial esophageal cancer and 75 years for early gastric cancer and gastric adenoma; no patients had a BMI >35 kg/m2.
Statistical Information
P-Value
0.012
Statistical Significance
p<0.05
Digital Object Identifier (DOI)
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