Endoscopy
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The main criteria for assessing conscious sedation (perhaps now more correctly termed "moderate sedation/analgesia") continue to be patient satisfaction and comfort, short duration, amnesia, and above all, patient safety. The problems reviewed last year - including the increasing pressure on endoscopy units to perform yet more procedures, reduce costs, and achieve shorter patient turn-around times - certainly have not gone away. Studies reviewed this year suggest that although many endoscopic procedures, such as oesophagogastroduodenoscopy (OGD), colonoscopy, and endoscopic ultrasonography (EUS) can indeed be performed without intravenous sedation, many patients still prefer to be sedated. ⋯ Warm water is a cheap and effective way of reducing colonic spasm during colonoscopy, and intraluminal peppermint oil is a good antispasmodic in the stomach as well as the colon. Sedation should still be regarded as one part of an overall "endoscopy package". Finally, more attention needs to be given to patients' complaints regarding what are often considered by endoscopists to be "trivial complications" if the patients are to have a positive experience of their examination that will lead to them being prepared to come back a second time.