As long as they have received the proper training, nonanesthesiologist physicians and nurses can administer propofol sedation to low-risk patients safely during elective endoscopic procedures, according to a new consensus statement issued jointly by four national gastroenterology and hepatology groups.
The statement—prepared by the American Association for the Study of Liver Diseases, American College of Gastroenterology, American Gastroenterological Association, and American Society for Gastrointestinal Endoscopy—is based on a review of 25 studies comprising almost 470,000 cases in which propofol sedation was administered by nonanesthesiologists during endoscopic procedures.
When administered by properly trained medical professionals, such sedation is safe as well as both cost effective and clinically effective, wrote Dr. John J. Vargo and his coauthors. “Most studies show that nonanesthesiologist–administered propofol sedation is superior to standard sedation regimens regarding time to sedation and time to recovery,” wrote Dr. Vargo of the Cleveland Clinic and his colleagues.
“Patient satisfaction with propofol sedation ranges from equivalent to slightly superior when compared to standard sedation. The use of anesthesiologist-administered propofol for healthy individuals undergoing elective endoscopy without risk factors for sedation-related complications is very costly, with no demonstrated improvement in patient safety or procedural outcome.”
The statement was published in the December issue of Gastroenterology.