Mount Sinai School of Medicine, New York, NY, USA.
Aliment Pharmacol Ther. 2010 Aug;32(3):425-42. doi: 10.1111/j.1365-2036.2010.04352.x. Epub 2010 May 8.
Guidelines and practice standards for sedation in endoscopy have been developed by various national professional societies. No attempt has been made to assess consensus among internationally recognized experts in this field.
To identify areas of consensus and dissent among international experts on a broad range of issues pertaining to the practice of sedation in digestive endoscopy.
Thirty-two position statements were reviewed during a 1 (1/2)-day meeting. Thirty-two individuals from 12 countries and four continents, representing the fields of gastroenterology, anaesthesiology and medical jurisprudence heard evidence-based presentations on each statement. Level of agreement among the experts for each statement was determined by an open poll.
The principle recommendations included the following: (i) sedation improves patient tolerance and compliance for endoscopy, (ii) whenever possible, patients undergoing endoscopy should be offered the option of having the procedure either with or without sedation, (iii) monitoring of vital signs as well as the levels of consciousness and pain/discomfort should be performed routinely during endoscopy, and (iv) endoscopists and nurses with appropriate training can safely and effectively administer propofol to low-risk patients undergoing endoscopic procedures.
While the standards of practice vary from country to country, there was broad agreement among participants regarding most issues pertaining to sedation during endoscopy.
各种国家专业学会已经制定了内镜检查镇静的指南和实践标准。但尚未尝试评估该领域国际公认专家之间的共识。
确定国际专家在与消化内镜镇静实践相关的广泛问题上的共识和分歧领域。
在为期 1 天半的会议上，对 32 项立场声明进行了审查。来自 12 个国家和四大洲的 32 名代表，分别来自胃肠病学、麻醉学和医学法学领域，听取了关于每项声明的循证演示。通过公开投票确定专家对每项声明的共识程度。
主要建议包括：（i）镇静可提高患者对内镜检查的耐受性和依从性，（ii）只要可能，应向接受内镜检查的患者提供选择是否接受镇静的机会，（iii）在整个内镜检查过程中应常规监测生命体征以及意识和疼痛/不适程度，以及（iv）经过适当培训的内镜医师和护士可以安全有效地为接受内镜手术的低风险患者施用异丙酚。
尽管实践标准因国家而异，但与会者对与内镜检查镇静相关的大多数问题基本达成共识。
