Endoscopy 2005; 37(2): 161-166
DOI: 10.1055/s-2004-826143
Original Article
© Georg Thieme Verlag KG Stuttgart · New York

Changing Patterns of Sedation and Monitoring Practice during Endoscopy: Results of a Nationwide Survey in Switzerland

L.  T.  Heuss1 , F.  Froehlich2 , C.  Beglinger1
  • 1Department of Gastroenterology, University Hospital, Basle, Switzerland
  • 2Division of Gastroenterology, Policlinique Médicale Universitaire, Lausanne, Switzerland
Further Information

Publication History

Submitted 26 March 2004

Accepted after Revision 1 September 2004

Publication Date:
03 February 2005 (online)

Background and Study Aims: Little is known about how practices in sedation and in monitoring during gastrointestinal endoscopy and the complication rates of sedation have changed over time. The aim of this nationwide survey was to assess the present practice among Swiss gastroenterologists, with a particular focus on the use of propofol, and to compare the results with similar data obtained in 1990.
Patients and Methods: At the end of 2003 a questionnaire (similar to the one used in 1990) was sent to all 249 Swiss gastroenterologists. The response rate was 72.3 %. Data from 179 953 endoscopies performed during the previous 12 months were analyzed for the study.
Results: In 2003 sedation was used in 78 % of esophagogastroduodenoscopies and colonoscopies (compared with 60 % in 1990), with midazolam being the most commonly used medication. The drugs were mostly administered by the endoscopy nurse, via an intravenous cannula. Oximetry monitoring was used in more than 95 % of examinations (compared with 2.5 % in 1990). The overall sedation-related morbidity was 0.18 % and the mortality rate was 0.0014 %. Of the 180 respondents, 77 (43 %) reported that they been using propofol regularly for a median time period of 23 months. The 62 respondents (34 %) who used propofol without the assistance of an anesthesiologist had performed a total of 82 620 procedures. The morbidity (defined as the need for bag-ventilation) in this group of patients was 0.19 % and no deaths were reported.
Conclusions: The use of sedation in gastrointestinal endoscopy has markedly increased over the last 13 years and the use of electronic monitoring has become standard practice. A significant percentage of Swiss gastroenterologists report that they use propofol, mainly in a hospital setting.

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L. T. Heuss, M. D.

Department of Gastroenterology, University Hospital Basel

Petersgraben 4 · CH-4031 Basel · Switzerland

Fax: +41-61-265-5352

Email: lheuss@uhbs.ch

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