• Scand. J. Gastroenterol. · Dec 2011

    Nurse-administered propofol sedation for gastrointestinal endoscopic procedures: first Nordic results from implementation of a structured training program.

    • Charlotte Slagelse, Peter Vilmann, Pernille Hornslet, Anne Hammering, and Teit Mantoni.
    • Department of Endoscopy, Copenhagen University Hospital Gentofte, Hellerup, Denmark.
    • Scand. J. Gastroenterol. 2011 Dec 1;46(12):1503-9.

    IntroductionProper training to improve safety of NAPS (nurse-administered propofol sedation) is essential.ObjectiveTo communicate our experience with a training program of NAPS.Materials And MethodsIn 2007, a training program was introduced for endoscopists and endoscopy nurses in collaboration with the Department of Anaesthesiology. During a 2.5-year period, eight nurses were trained. Propofol was given as monotherapy. The training program for nurses consisted of a 6-week course including theoretical and practical training whereas the training program for endoscopists consisted of 2.5 h of theory. Patients were selected based on strict criteria including patients in ASA (American Society of Anesthesiologists) group I-III.Results2527 patients undergoing 2.656 gastrointestinal endoscopic procedures were included. The patients were ASA group I, II and III in 34.7%, 56% and 9,3%, respectively. Median dose of propofol was 300 mg. No mortality was noted. 119 of 2527 patients developed short lasting hypoxia (4.7%); 61 (2.4%) needed suction; 22 (0.9%) required bag-mask ventilation and 8 (0.3%) procedures had to be discontinued. In 11 patients (0.4%), anesthetic assistance was called due to short lasting desaturation. 34 patients (1.3%) experienced a change in blood pressure greater than 30%.ConclusionNAPS provided by properly trained nurses according to the present protocol is safe and only associated with a minor risk (short lasting hypoxia 4.7%). National or international structured training programs are at present few or non-existing. The present training program has documented its value and is suggested as the basis for the current development of guidelines.

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