Endoscopist-Driven Sedation Practices in South Korea: Re-evaluation Considering the Nationwide Survey in 2019
2
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Background/Aims: This study aimed to determine changes in endoscopist-driven sedation practices 5 years after the first nationwide survey in 2014 by the Korean Society of Gastrointestinal Endoscopy (KSGE). Methods: A 59-item survey covering current practices was electronically mailed to all members of the KSGE in 2019. Results: In total, 955 (12.8%) out of 7,486 questionnaires were returned. A total of 738 (77.7%) out of 955 respondents attended dedicated sedation education programs. The American Society of Anesthesiologists class was recorded by 464 (51.2%) out of 907 respondents. The recording rate was higher in respondents who completed sedation education (p=0.014) and worked in general or tertiary hospitals (p<0.001). Compared to that reported in the previous survey, the reported use of propofol was higher in 2019. The respondents had higher satisfaction scores for propofol-based sedation compared with midazolam monotherapy (p<0.001). The rates of oxygen supplementation (p<0.001) and oxygen saturation level monitoring (p<0.001) during sedative endoscopy were higher in 2019 than in the previous survey. A total of 876 (98.4%) out of 890 respondents reported a separate recovery bay, and 615 (70.5%) out of 872 respondents reported that personnel were assigned solely to the recovery bay. Conclusions: Endoscopist-driven sedation and monitoring practices in 2019 were significantly different than those in 2014. The respondents favored propofol-based sedation and utilized oxygen supplementation and monitoring of O2 saturation more frequently in 2019 than in 2014.
Abstract
Background/Aims: This study aimed to determine changes in endoscopist-driven sedation practices 5 years after the first nationwide survey in 2014 by the Korean Society of Gastrointestinal Endoscopy (KSGE). Methods: A 59-item survey covering current practices was electronically mailed to all members of the KSGE in 2019. Results: In total, 955 (12.8%) out of 7,486 questionnaires were returned. A total of 738 (77.7%) out of 955 respondents attended dedicated sedation education programs. The American Society of Anesthesiologists class was recorded by 464 (51.2%) out of 907 respondents. The recording rate was higher in respondents who completed sedation education (p=0.014) and worked in general or tertiary hospitals (p<0.001). Compared to that reported in the previous survey, the reported use of propofol was higher in 2019. The respondents had higher satisfaction scores for propofol-based sedation compared with midazolam monotherapy (p<0.001). The rates of oxygen supplementation (p<0.001) and oxygen saturation level monitoring (p<0.001) during sedative endoscopy were higher in 2019 than in the previous survey. A total of 876 (98.4%) out of 890 respondents reported a separate recovery bay, and 615 (70.5%) out of 872 respondents reported that personnel were assigned solely to the recovery bay. Conclusions: Endoscopist-driven sedation and monitoring practices in 2019 were significantly different than those in 2014. The respondents favored propofol-based sedation and utilized oxygen supplementation and monitoring of O2 saturation more frequently in 2019 than in 2014.
참고문헌 (23)
- Protopapas AA, "Endoscopic sedation practices of Greek gastroenterologists : a nationwide survey", Ann Gastroenterol, 33, pp.366~373 (2020)
- Friedrich K, "Endoscopist-administered propofol sedation is safe : a prospective evaluation of 10, 000patients in an outpatient practice", J Gastrointestin Liver Dis, 21, pp.259~263 (2012)
- Sieg A, "Safety analysis of endoscopist-directed propofol sedation : a prospective, national multicenter study of 24 441 patients in German outpatient practices", J Gastroenterol Hepatol, 29, pp.517~523 (2014)
- ASGE Standards of Practice Committee, "Guidelines for sedation and anesthesia in GI endoscopy", Gastrointest Endosc, 87, pp.327~337 (2018)
- Igea F, "Sedation for gastrointestinal endoscopy", Endoscopy, 46, pp.720~731 (2014)
- 문성훈, "Sedation Regimens for Gastrointestinal Endoscopy", Clinical Endoscopy, 47(2), pp.135~140 (2014), 대한소화기내시경학회
- Lucendo AJ, "Gastrointestinal endoscopy sedation and monitoring practices in Spain : a nationwide survey in the year 2014", Endoscopy, 47, pp.383~390 (2015)
- Fanti L, "Sedation and monitoring for gastrointestinal endoscopy : a nationwide web survey in Italy", Dig Liver Dis, 43, pp.726~730 (2011)
- Cohen LB, "Endoscopic sedation in the United States : results from a nationwide survey", Am J Gastroenterol, 101, pp.967~974 (2006)
- Ferreira AO, "Endoscopic sedation and monitoring practices in Portugal : a nationwide web-based survey", Eur J Gastroenterol Hepatol, 27, pp.265~270 (2015)
- 이창균, "Room for Quality Improvement in Endoscopist-Directed Sedation: Results from the First Nationwide Survey in Korea", Gut and Liver, 10(1), pp.83~94 (2016), 거트앤리버 소화기연관학회협의회
- 김정욱, "Accredited Endoscopy Unit Program of Korea: Overview and Qualification", Clinical Endoscopy, 52(5), pp.426~430 (2019), 대한소화기내시경학회[DOI]
- Jun Kyu Lee, "Updates on the Sedation for Gastrointestinal Endoscopy", Clinical Endoscopy, 52(5), pp.451~457 (2019), 대한소화기내시경학회[DOI]
- 이태희, "Updates on the Facilities, Procedures, and Performance of the Accredited Endoscopy Unit", Clinical Endoscopy, 52(5), pp.431~442 (2019), 대한소화기내시경학회[DOI]
- Vargo JJ, "Minimizing complications : sedation and monitoring", Gastrointest Endosc Clin N Am, 17, pp.11~28 (2007)
- Nimmagadda U, "Preoxygenation with tidal volume and deep breathing techniques : the impact of duration of breathing and fresh gas flow", Anesth Analg, 92, pp.1337~1341 (2001)
- Wang D, "The use of propofol as a sedative agent in gastrointestinal endoscopy : a meta-analysis", PLoS One, 8, pp.e53311~ (2013)
- 이준규, "진정내시경시 비마취과의사에 의한 프로포폴 투여의 안전성", 대한소화기학회지, 69(1), pp.55~58 (2017), 대한소화기학회[DOI]
- Gwan Woo Hong, "Comparison of Fentanyl versus Meperidine in Combination with Midazolam for Sedative Colonoscopy in Korea", Clinical Endoscopy, 53(5), pp.562~567 (2020), 대한소화기내시경학회[DOI]
- Hayee B, "Midazolam with meperidine or fentanyl for colonoscopy : results of a randomized trial", Gastrointest Endosc, 69(3 Pt 2), pp.681~687 (2009)
- Dumonceau JM, "Non-anesthesiologist administration of propofol for gastrointestinal endoscopy : European Society of Gastrointestinal Endoscopy, European Society of Gastroenterology and Endoscopy Nurses and Associates Guideline. Updated June 2015", Endoscopy, 47, pp.1175~1189 (2015)
- Francis DL, "Quality improvement project eliminates falls in recovery area of high volume endoscopy unit", BMJ Qual Saf, 20, pp.170~173 (2011)
- Kim SH, "The addition of capnography to standard monitoring reduces hypoxemic events during gastrointestinal endoscopic sedation : a systematic review and meta-analysis", Ther Clin Risk Manag, 14, pp.1605~1614 (2018)