Propofol Alone Titrated to Deep Sedation Versus Propofol in Combination with Narcotics and/Or Benzodiazepines and Targeted to Moderate Sedation for Colonoscopy

2006 ◽  
Vol 63 (5) ◽  
pp. AB192 ◽  
Author(s):  
Megan E. Vannatta ◽  
Douglas K. Rex
Endoscopy ◽  
2020 ◽  
Vol 53 (01) ◽  
pp. 65-71
Author(s):  
Mauro Manno ◽  
Simona Deiana ◽  
Tommaso Gabbani ◽  
Matteo Gazzi ◽  
Alessandro Pignatti ◽  
...  

Abstract Background Several scientific societies have endorsed non-anesthesiologist sedation (NAS) during gastrointestinal endoscopy, considering it a safe procedure when administered by adequately trained personnel. This study aimed to evaluate the occurrence of adverse events after implementation of the European Society of Gastrointestinal Endoscopy (ESGE) and European Society of Gastroenterology and Endoscopy Nurses and Associates (ESGENA) sedation training program. Methods From January 2017 to August 2018, data from all consecutive endoscopic procedures in adults (≥ 18 years) performed at our endoscopy unit were collected using an electronic reporting system. Results All staff (physicians and nurses) completed the ESGE-ESGENA sedation course. In total, 12 132 patients underwent endoscopic procedures, 10 755 (88.6 %) of which were performed in a non-anesthesiological setting. Of these, about 20 % used moderate sedation with midazolam + fentanyl and 80 % used deep sedation with additional propofol. No sentinel, 5 (0.05 %) moderate risk, and 18 (0.17 %) minor risk adverse events occurred, all during moderate or deep sedation, and all managed by endoscopy staff without the need for anesthesiologist assistance. Conclusions After completing the ESGE-ESGENA sedation training program, the rate of adverse events was very low in our institution. The findings support implementation of the program in all digestive endoscopy units and inclusion in the curriculum for physicians and nurses to ensure safe endoscopic procedures.


Author(s):  
David Banks ◽  
David Werner

The sustainability of a sedation service depends on its ability to generate revenue, both for the providers and for the facility/institution. A complete understanding of the process of coding and billing to achieve maximum reimbursement is necessary for planning a new sedation service, as well as maintaining and expanding an existing one. This section discusses CPT coding and billing for deep sedation, moderate sedation, provider consulting, and facility fees. Coding and billing for deep sedation involves using CPT codes for anesthesia services. Coding and billing for moderate sedation involves the use of the moderate sedation CPT codes that were updated for 2017. Coding and billing for hospital services associated with providing deep sedation involves the use of facility revenue codes.


2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
K H Li ◽  
T Sang ◽  
C P Chan ◽  
M Gong ◽  
G Li ◽  
...  

Abstract Objectives This meta-analysis and systematic review seeks to compare both characteristic parameters and procedural outcomes of catheter ablation in patients under GA/deep sedation and mild/moderate sedation. Background Catheter ablation has become a widely applied intervention for treating symptomatic AF and arrhythmias that are refractory to medical therapy. It can be conducted through from mild sedation to general anesthesia. Methods PubMed and Embase were searched up to July 2018 for randomized controlled trials, cohort and observational studies that assessed the outcomes of catheter ablation under GA/deep sedation or mild/moderate sedation. 12 studies were included in this meta-analysis after screening with the inclusion and exclusion criteria. Heterogeneity between studies and publication bias was evaluated by I2 index and Egger's regression, respectively. Results Our meta-analysis found catheter AF ablation with GA/deep sedation to be associated with reduced risk of recurrence (RR: 0.79, 95% CI: 0.56 to 1.13, P=0.20) and complications (RR: 0.95, 95% CI: 0.64 to 1.42, P=0.82), though statistically insignificant. In terms of procedural parameters, there was non-significant difference between the two groups when both procedural time (SMD: −0.13, 95% CI: −0.90 to 0.63, P=0.74) and fluoroscopy time (SMD: −0.41, 95% CI: −1.40 to 0.58, P=0.41) were considered. Multivariate meta-regression demonstrated hypertension as an independent moderating factor for complication risk. Complications Comparison Conclusion Apart from an increased likelihood of procedural success, ablation by GA/deep sedation was found to be non-significantly different from the mild/moderate sedation approach in both procedural parameters and outcome measures.


2010 ◽  
Vol 71 (5) ◽  
pp. AB327
Author(s):  
Georgios Tribonias ◽  
Konstantinos Konstantinidis ◽  
Angeliki Theodoropoulou ◽  
Emmanouil Vardas ◽  
Konstantinos Karmiris ◽  
...  

2022 ◽  
Vol 13 (1) ◽  
pp. 38-45
Author(s):  
Hulya Yilmaz AK ◽  
Yasemin Ozsahin ◽  
Mehmet Ali Yesiltas ◽  
Sukru Arslan ◽  
Cem Bostan ◽  
...  

Background: During the transesophageal echocardiography (TEE) procedure, as in many other diagnostic semi-invasive applications, moderate sedation is preferred over deep sedation. Rarely, patients who cannot tolerate moderate sedation may require deep sedation when difficulties are encountered during TEE probe insertion. Although many different methods have been tried for the TEE procedure in clinical practice, the most appropriate sedation method is still controversial. Aims and Objectives: We aimed to evaluate the clinical effects of three different sedoanalgesia methods consisting of midazolam, propofol, and midazolam-pethidine combination protocols applied for conscious sedation in the patients undergoing a TEE procedure, and to evaluate the patient and doctor satisfaction during the procedure. Materials and Methods: One-hundred twenty five patients who underwent TEE for diagnostic purposes in our hospital were included consecutively in our prospective randomized trial. The patients were divided into three groups as those who were administered midazolam (group M), propofol (group Pr), and midazolam-pethidine (group MPe) during the TEE procedure. Results: In the MPe group, both patient and doctor satisfaction were significantly higher than the two groups. The rate of difficulty in probe placement was lower in the Pr and MPe groups compared to the M group (P<0.05). Conclusion: In this study, it has been observed that conscious sedation with the combination of midazolam-pethidine was significantly advantageous in terms of patient and physician satisfaction compared to the use of only midazolam and only propofol.


2017 ◽  
Vol 73 (8) ◽  
pp. 468-472 ◽  
Author(s):  
Musa Genccelep ◽  
Abdullah Karasu

Five clinically healthy Akkaraman rams were used. Xylazine was administered intramuscularly at an initial dose of 0.4 mg/kg to induce sedation. The second, third and fourth doses were 20% larger than the previous dose, that is, 0.48, 0.57 and 0.68 mg/kg doses, respectively. They were administered intramuscularly four times at 4-day intervals. The rectal temperature, heart rate and respiratory rate, as well as the rumen motility of all animals, were evaluated before and after xylazine administration. The depths of sedation and analgesia and the control of reflexes, along with various biochemical parameters, were studied. Although the respiration rate increased until the 15th min, it approached the control value at the 30th min and decreased after the 45th min. Ruminal contractions progressively decreased from the 5th min to the 60th min. All levels of sedation were observed in all sheep. The degree of analgesic effect was 0 during mild and moderate sedation periods, and 1–2 during deep sedation. Of all biochemical parameters assessed, only the glucose concentration increased. It was therefore concluded that in order to obtain the same sedation level in sheep in the 4 days following an administration of xylazine, the previous dose should be increased by 20%.


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