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Orel R, Brecelj J, Dias JA, et al. Review on sedation for gastrointestinal tract endoscopy in children by non-anesthesiologists. World J Gastrointest Endosc. 2015;7(9):895-911doi: 10.4253/wjge.v7.i9.895.
Orel, R., Brecelj, J., Dias, J. A., Romano, C., Barros, F., Thomson, M., & Vandenplas, Y. (2015). Review on sedation for gastrointestinal tract endoscopy in children by non-anesthesiologists. World journal of gastrointestinal endoscopy, 7(9), 895-911. https://doi.org/10.4253/wjge.v7.i9.895
Orel, Rok, et al. "Review on sedation for gastrointestinal tract endoscopy in children by non-anesthesiologists." World journal of gastrointestinal endoscopy vol. 7,9 (2015): 895-911. doi: https://doi.org/10.4253/wjge.v7.i9.895
Orel R, Brecelj J, Dias JA, Romano C, Barros F, Thomson M, Vandenplas Y. Review on sedation for gastrointestinal tract endoscopy in children by non-anesthesiologists. World J Gastrointest Endosc. 2015 Jul 25;7(9):895-911. doi: 10.4253/wjge.v7.i9.895. PMID: 26240691; PMCID: PMC4515424.
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World J Gastrointest Endosc. 2015 Jul 25;7(9):895-911. doi: 10.4253/wjge.v7.i9.895.

Review on sedation for gastrointestinal tract endoscopy in children by non-anesthesiologists.

World journal of gastrointestinal endoscopy

Rok Orel, Jernej Brecelj, Jorge Amil Dias, Claudio Romano, Fernanda Barros, Mike Thomson, Yvan Vandenplas

Affiliations

  1. Rok Orel, Jernej Brecelj, Children's Hospital, University Medical Centre Ljubljana, and Medical Faculty, University of Ljubljana, 1000 Ljubljana, Slovenia.

PMID: 26240691 PMCID: PMC4515424 DOI: 10.4253/wjge.v7.i9.895

Abstract

AIM: To present evidence and formulate recommendations for sedation in pediatric gastrointestinal (GI) endoscopy by non-anesthesiologists.

METHODS: The databases MEDLINE, Cochrane and EMBASE were searched for the following keywords "endoscopy, GI", "endoscopy, digestive system" AND "sedation", "conscious sedation", "moderate sedation", "deep sedation" and "hypnotics and sedatives" for publications in English restricted to the pediatric age. We searched additional information published between January 2011 and January 2014. Searches for (upper) GI endoscopy sedation in pediatrics and sedation guidelines by non-anesthesiologists for the adult population were performed.

RESULTS: From the available studies three sedation protocols are highlighted. Propofol, which seems to offer the best balance between efficacy and safety is rarely used by non-anesthesiologists mainly because of legal restrictions. Ketamine and a combination of a benzodiazepine and an opioid are more frequently used. Data regarding other sedatives, anesthetics and adjuvant medications used for pediatric GI endoscopy are also presented.

CONCLUSION: General anesthesia by a multidisciplinary team led by an anesthesiologist is preferred. The creation of sedation teams led by non-anesthesiologists and a careful selection of anesthetic drugs may offer an alternative, but should be in line with national legislation and institutional regulations.

Keywords: Analgesics; Anesthetics; Colonoscopy; Gastro-intestinal endoscopy; Gastroscopy; Pediatric ages; Sedatives

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