Endoscopic Sedation in the United States: Results from a Nationwide Survey
- 1 May 2006
- journal article
- Published by Ovid Technologies (Wolters Kluwer Health) in The American Journal of Gastroenterology
- Vol. 101 (5), 967-974
- https://doi.org/10.1111/j.1572-0241.2006.00500.x
Abstract
The introduction of new sedative agents as well as a desire for improved patient satisfaction and greater efficiency has changed the practice of endoscopic sedation. This survey was designed to provide national and regional data on endoscopic sedation and monitoring practices within the United States. A 22-item survey regarding current practices of endoscopy and sedation was mailed to 5,000 American College of Gastroenterology physician members nationwide. A total of 1,353 questionnaires (27.1%) were returned. Respondents performed an average of 12.3 esophagogastroduodenoscopies (EGDs) and 22.3 colonoscopies per wk. Endoscopic procedures were performed within a hospital setting (55.2) more often than at an ambulatory center (35.8%) or private office (8.8%). The vast majority of EGDs and colonoscopies (>98%) were performed with endoscopic sedation. Almost three quarters (74.3%) of the respondents used a narcotic and benzodiazepine for sedation, while propofol was preferred by 25.7%. Sedation practices varied considerably within different geographic regions of the United States. Respondents routinely monitored vital signs and pulse oximetry (99.2% and 98.6%, respectively), and supplemental oxygen was administered to all patients during EGD by 72.7% of endoscopists. Endoscopist satisfaction with sedation was greater among those using propofol than conventional sedation (10 vs 8, p < 0.0001). During the past 15 yr, the volume of procedures performed by endoscopists in the United States has increased two- to fourfold. Propofol is currently being used for sedation in approximately one quarter of all endoscopies in the United States. The findings from this survey may help in the formulation of updated policies and practice guidelines pertaining to endoscopic sedation.Keywords
This publication has 18 references indexed in Scilit:
- Sedation for Gastrointestinal Endoscopy: New Practices, New EconomicsThe American Journal of Gastroenterology, 2005
- Science and Politics of PropofolThe American Journal of Gastroenterology, 2005
- Preparation, Premedication, and SurveillanceEndoscopy, 2005
- Changing Patterns of Sedation and Monitoring Practice during Endoscopy: Results of a Nationwide Survey in SwitzerlandEndoscopy, 2005
- Propofol: A gastroenterologist's perspectiveGastrointestinal Endoscopy Clinics of North America, 2004
- A prospective study of colonoscopy practice in the UK today: are we adequately prepared for national colorectal cancer screening tomorrow?Gut, 2004
- Current capacity for endoscopic colorectal cancer screening in the United States: data from the National Cancer Institute Survey of Colorectal Cancer Screening PracticesAmerican Journal Of Medicine, 2003
- Changing patterns of sedation use for routine out-patient diagnostic gastroscopy between 1989 and 1998Alimentary Pharmacology & Therapeutics, 2001
- Prospective audit of upper gastrointestinal endoscopy in two regions of England: safety, staffing, and sedation methods.Gut, 1995
- Sedation for upper gastrointestinal endoscopy: results of a nationwide survey.Gut, 1991