Quality of sedation with propofol administered by non-anesthetists in a digestive endoscopy unit: the results of a one year experience.

ABSTRACT

INTRODUCTION: research has shown that an endoscopist-nurse clinical team can perform sedation with propofol effectively, safely and efficiently. To do so, it is essential to provide specific and appropriate training in the necessary skills. The main aim of the present study was to evaluate the quality of the sedation procedure administered by non-anesthetists in a digestive endoscopy unit, one year after its introduction. METHODS: a prospective cohort study was performed in patients given propofol sedation by non-anesthetists. Subsequently, a random sample of clinical records was selected in order to evaluate the adherence of professionals to the quality criteria and to assess the rate of adverse events related to sedation. RESULTS: a total of 595 procedures were performed under propofol sedation during the study period. The rate of adverse events was 2.4% (n = 507), mainly involving hypotension and hypoxemia. Adherence to the sedation procedure was above 80% for most of the applicable criteria, although it was lower for the completion of ASA risk evaluation. CONCLUSIONS: the results of the study suggest that propofol can be administered safely and effectively by a qualified endoscopist-nurse team, in patients with an ASA I-II risk. Audits of adherence by medical staff to the recommended procedure facilitate the identification of areas for improvement; further work is needed on the aspects that have not yet been consolidated.