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Rev Esp Enferm Dig ; 110(4): 237-239, 2018 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-29578350

RESUMO

INTRODUCTION: deep sedation with propofol monitored by an endoscopist in different endoscopy units is a controversial subject and the source of conflicts of interest between the various scientific societies of Anesthesiology and Gastroenterology. Many studies have already demonstrated the efficacy, efficiency and low incidence of complications associated with sedation when under the control of a trained endoscopist vs an anesthesiologist. MATERIAL AND METHODS: the rate of severe cardiorespiratory complications during various endoscopic examinations (gastroscopy, colonoscopy, endoscopic retrograde cholangiopancreatography [ERCP] and endoscopic ultrasound [EUS]) where sedation was controlled by an endoscopist within our unit, from 2011 to 2016, was reviewed. RESULTS: during the study period, 33,195 examinations were analyzed. The rate of cardiorespiratory complications was 0.13% and the majority were severe desaturations. Most cases responded to an opening in the airway associated with the interruption of drug infusion and an ambu bag was required in a few cases. There were no statistically significant differences between the different groups, except for mean age, risk by type of examination and ASA risk, where the difference between ERCP and the rest of examinations was statistically significant. CONCLUSION: there is a high level of evidence in the scientific literature suggesting that sedation controlled by a trained endoscopist is safe, effective and efficient. However, further prospective studies are required in order to confirm this conclusion due to the fact that the majority of studies to date are retrospective.


Assuntos
Sedação Consciente/efeitos adversos , Endoscopia Gastrointestinal/efeitos adversos , Cardiopatias/induzido quimicamente , Hipnóticos e Sedativos/efeitos adversos , Propofol/efeitos adversos , Transtornos Respiratórios/induzido quimicamente , Adulto , Idoso , Idoso de 80 Anos ou mais , Endoscopia Gastrointestinal/métodos , Feminino , Cardiopatias/epidemiologia , Cardiopatias/mortalidade , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Monitorização Fisiológica , Transtornos Respiratórios/epidemiologia , Transtornos Respiratórios/mortalidade , Estudos Retrospectivos
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