• Ann Acad Med Singap · Jan 2022

    Academy of Medicine, Singapore clinical guideline on the use of sedation by non-anaesthesiologists during gastrointestinal endoscopy in the hospital setting.

    • Tiing Leong Ang, Edwin Seet, Yaw Chong Goh, Wee Khoon Ng, Calvin Jianyi Koh, Hock Foong Lui, James Weiquan Li, Aung Myint Oo, Kieron Boon Leng Lim, Kok Sun Ho, Min Hoe Chew, Wai Leong Quan, Damien Meng Yew Tan, Kheng Hong Ng, Hak Su Goh, Wai Kit Cheong, Philip Tseng, and Khoon Lin Ling.
    • Department of Gastroenterology and Hepatology, Changi General Hospital, Singapore.
    • Ann Acad Med Singap. 2022 Jan 1; 51 (1): 24-39.

    IntroductionIn Singapore, non-anaesthesiologists generally administer sedation during gastrointestinal endoscopy. The drugs used for sedation in hospital endoscopy centres now include propofol in addition to benzodiazepines and opiates. The requirements for peri-procedural monitoring and discharge protocols have also evolved. There is a need to develop an evidence-based clinical guideline on the safe and effective use of sedation by non-anaesthesiologists during gastrointestinal endoscopy in the hospital setting.MethodsThe Academy of Medicine, Singapore appointed an expert workgroup comprising 18 gastroenterologists, general surgeons and anaesthesiologists to develop guidelines on the use of sedation during gastrointestinal endoscopy. The workgroup formulated clinical questions related to different aspects of endoscopic sedation, conducted a relevant literature search, adopted Grading of Recommendations, Assessment, Development and Evaluation (GRADE) methodology and developed recommendations by consensus using a modified Delphi process.ResultsThe workgroup made 16 recommendations encompassing 7 areas: (1) purpose of sedation, benefits and disadvantages of sedation during gastrointestinal endoscopy; (2) pre-procedural assessment, preparation and consent taking for sedation; (3) Efficacy and safety of drugs used in sedation; (4) the role of anaesthesiologist administered sedation during gastrointestinal endoscopy; (5) performance of sedation; (6) post-sedation care and discharge after sedation; and (7) training in sedation for gastrointestinal endoscopy for non-anaesthesiologists.ConclusionThese recommendations serve to guide clinical practice during sedation for gastrointestinal endoscopy by non-anaesthesiologists in the hospital setting.

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