Review article

Moderate sedation for endoscopy: Sedation regimens for non-anaesthesiologists

Douglas Rex

Research output: Contribution to journalArticle

85 Citations (Scopus)

Abstract

Background: Moderate sedation is a drug-induced depression of consciousness during which patients respond purposefully to verbal commands with or without light tactile stimulation. Moderate sedation is typically accepted in the anaesthesia community as an appropriate target for sedation by non-anaesthesiologists. Aim: To describe drug regimens that can be successfully and safely targeted to moderate sedation for endoscopy by non- anaesthesiologists. Results: Moderate sedation can be achieved using narcotics and benzodiazepines. There is interest in some countries in propofol for endoscopy, which is often viewed as an agent for deep sedation. Indeed, propofol cannot be targeted to moderate sedation for endoscopy as a single agent because of coughing during upper endoscopy and pain withdrawal responses during colonoscopy. Pre-treatment with low doses of narcotic and/or benzodiazepine blocks these effects, allowing propofol to be targeted to moderate sedation. Fospropofol, a prodrug of propofol in clinical development, can also be targeted to moderate sedation if co-administered with narcotic. Conclusion: Moderate sedation provides a safety margin when compared with deep sedation and general anaesthesia. Development of protocols that target agents such as propofol to moderate sedation will expand the sedation agents available to non-anaesthesiologists and help ensure that this expansion occurs safely.

Original languageEnglish
Pages (from-to)163-171
Number of pages9
JournalAlimentary Pharmacology and Therapeutics
Volume24
Issue number2
DOIs
StatePublished - Jul 2006

Fingerprint

Conscious Sedation
Endoscopy
Propofol
Narcotics
Deep Sedation
Benzodiazepines
Prodrugs
Touch
Colonoscopy
Consciousness
Pharmaceutical Preparations
General Anesthesia
Anesthesia
Safety
Pain

ASJC Scopus subject areas

  • Pharmacology (medical)
  • Pharmacology, Toxicology and Pharmaceutics(all)

Cite this

Review article : Moderate sedation for endoscopy: Sedation regimens for non-anaesthesiologists. / Rex, Douglas.

In: Alimentary Pharmacology and Therapeutics, Vol. 24, No. 2, 07.2006, p. 163-171.

Research output: Contribution to journalArticle

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