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World J Gastrointest Endosc. Feb 16, 2013; 5(2): 47-55
Published online Feb 16, 2013. doi: 10.4253/wjge.v5.i2.47
Sedation and monitoring for gastrointestinal endoscopy
Somchai Amornyotin
Somchai Amornyotin, Department of Anesthesiology and Siriraj Gastrointestinal Endoscopy Center, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
Author contributions: Amornyotin S soley contributed to the manuscript.
Correspondence to: Somchai Amornyotin, Associate Professor of Department of Anesthesiology, Department of Anesthesiology and Siriraj Gastrointestinal Endoscopy Center, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand. sisam@mahidol.ac.th
Telephone: +66-2-4197990 Fax: +66-2-4113256
Received: February 15, 2012
Revised: July 11, 2012
Accepted: December 1, 2012
Published online: February 16, 2013
Abstract

The safe sedation of patients for diagnostic or therapeutic procedures requires a combination of properly trained physicians and suitable facilities. Additionally, appropriate selection and preparation of patients, suitable sedative technique, application of drugs, adequate monitoring, and proper recovery of patients is essential. The goal of procedural sedation is the safe and effective control of pain and anxiety as well as to provide an appropriate degree of memory loss or decreased awareness. Sedation practices for gastrointestinal endoscopy (GIE) vary widely. The majority of GIE patients are ambulatory cases. Most of this procedure requires a short time. So, short acting, rapid onset drugs with little adverse effects and improved safety profiles are commonly used. The present review focuses on commonly used regimens and monitoring practices in GIE sedation. This article is to discuss the decision making process used to determine appropriate pre-sedation assessment, monitoring, drug selection, dose of sedative agents, sedation endpoint and post-sedation care. It also reviews the current status of sedation and monitoring for GIE procedures in Thailand.

Keywords: Sedation, Monitoring, Gastrointestinal endoscopy, Sedatives, Analgesics