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 en-bloc resection rate was 92.2% for superficial esophageal cancer and 100% for early gastric cancer and gastric adenoma.
- The median treatment duration was 68 minutes for superficial esophageal cancer and 84 minutes for early gastric cancer and gastric adenoma.
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 clinical practice perspective.
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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