Endoscopist-Directed Propofol

摘要

TERMINOLOGY SURROUNDING ENDOSCOPIST-DIRECTED PROPOFOL: Endoscopist-directed propofol (EDP) was a term that developed late in the history of propofol administration without involvement of anesthesia specialists. The term "EDP" was meant in part to emphasize that the process of delivering propofol without the involvement of anesthesia specialists remains under the control of, direction of, and the responsibility of the endoscopist. As such, EDP encompasses and includes the earlier term nurse-administered propofol sedation (NAPS). The introduction of NAPS for endoscopy to the United States is credited to John Walker, a private practice gastroenterologist in Medford, Oregon. With the cooperation and direction of an anesthesiologist working in his surgery center, Dr Walker developed protocols for registered nurses to carefully titrate propofol as a single agent for endoscopic procedures. Many early adopters, including myself, began the administration of propofol without anesthesia specialists by traveling with key nurses to Medford, Oregon, to observe Dr Walker's practice of NAPS.