On the Horizon The Future of Procedural Sedation

摘要

INTRODUCTION: According to the standards of practice committee of the American Society for Gastrointestinal Endoscopy (ASGE), "sedation is defined as a drug-induced depression in level of consciousness."1 Sedation is a fundamental aspect of gastrointestinal endoscopy (GIE) because it reduces anxiety and patient discomfort and also allows for better examination during endoscopy, thereby improving patient outcomes. The goal of sedation is to achieve a balance between the comfort aspects while preserving patient safety. Although sedation improves a patient's tolerance, it also increases both the cost and the risks of complications. Sedation itself is responsible for about 50% of all GIE complications.2'3 Sedation can be divided into 4 levels, ranging from minimal sedation to moderate, deep, and general anesthesia. Differences between various stages of sedation are described in Table 1. The most commonly used form of sedation in GIE is moderate sedation, also known as "conscious sedation." Some of the most commonly used agents for sedation and their antagonists in GIE are listed in Boxes 1 and 2, respectively. The targeted level of sedation depends on various factors like the type of examination, patient comorbidities, and the American Society of